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Abstract: SA-PO021

Fluid Shifts in Septic Shock During Early Hospitalization: A Bioelectrical Impedance Analysis (BIA) Study

Session Information

Category: Bioengineering

  • 400 Bioengineering

Authors

  • Cha, Susie, InBody, Cerritos, California, United States
  • Diaz Correa, Jesse E., Grupo Renal del Este, Caguas, Puerto Rico
  • Szerlip, Harold M., Medical University of South Carolina, Charleston, South Carolina, United States
Background

In the early management of septic shock, aggressive fluid resuscitation is crucial but carries the risk of fluid overload, potentially increasing mortality rates. However, our understanding of fluid distribution and dynamics in the body during this phase is limited. To address this, bioelectrical impedance analysis (BIA) has emerged as an effective tool for monitoring fluid status and guiding treatment decisions in the ICU.

Methods

An observational study was conducted in a university hospital ICU from Feb 2020 to Jul 2021 to assess fluid status in adult septic shock patients. Enrolled patients required mechanical ventilation for respiratory failure. Assessments using the InBody S10, a multifrequency BIA device, were performed at three time points: within 24 hrs of admission, and on days 3 and 7 of ICU stay. Parameters evaluated included extracellular water (ECW) ratio, ECW, intracellular water, and total body water. Fluid status changes were calculated by comparing subsequent measurements to the baseline (day 1). Survival data at 60 days were collected, with 11 survivors and 8 non-survivors.

Results

The study found that most ICU patients had persistent overhydration. Survivors showed a progressive decrease in fluid status, while non-survivors had a temporary increase on day 3, followed by a decrease on day 7, but still elevated compared to the baseline. These fluid fluctuations were mainly driven by changes in ECW, particularly in the legs and trunks. The relative change in fluid status highlighted divergent trends between the groups. Survivors had a sustained decrease of -0.3% and -1.4% on days 3 and 7, respectively, while non-survivors had a sustained increase of 2.2% and 3.0% on days 3 and 7, respectively, with significant differences observed between the groups at those time points. No significant weight change was observed.

Conclusion

Assessing individual changes was crucial due to patient variability. The findings offer insights into fluid shifts and the prognostic implications of BIA parameters in sepsis management, demonstrating its practicality for personalized measurements and informed treatment decisions.

Daily Fluid Change Comparing Survivors and Non-survivors