P596 - BIOELECTRICAL IMPEDANCE ANALYSIS IN CRITICALLY ILL PATIENTS: A SYSTEMATIC REVIEW OF ITS ROLE IN NUTRITIONAL ASSESSMENT AND CLINICAL MANAGEMENT

P596

BIOELECTRICAL IMPEDANCE ANALYSIS IN CRITICALLY ILL PATIENTS: A SYSTEMATIC REVIEW OF ITS ROLE IN NUTRITIONAL ASSESSMENT AND CLINICAL MANAGEMENT

L. Pegorer^1,*, J. R. Rios¹, A. Bedin-Pochini², G. Giorelli¹

¹Nutrology Academy, Rio de Janeiro, ²Hospital Israelita Albert Einstein , São Paulo, Brazil

Rationale: Assessing the nutritional status (NS) of critically ill patients (CIP) in the ICU is crucial for guiding decisions related to nutritional support, fluid management and medication dosing. Bioelectrical Impedance Analysis (BIA) shows promise as an important tool to enhance and support this assessment process

Methods: A systematic review was conducted using the terms "Bioelectrical Impedance Analysis (BIA)", "CIP", and "NS" at Pubmed in the last 10 years. Of 131 identified articles, 15 met the eligibility criteria. 

Results: Multiple studies show that phase angle (PhA) correlates positively with nutritional status. A low standardized PhA (SPhA) identifies malnutrition with 60.6% accuracy (AUC = 0.6060) and triples its likelihood (OR = 2.79; 95% CI: 1.39–5.61). PhA also correlates with BMI (r = 0.74) and skeletal muscle index (SMI) (r = 0.29), with cut-off points of PhA < 5.4° and SPhA < −0.79 effectively predicting severe malnutrition. BIA shows good correlation with CT for skeletal muscle mass (SMM) estimation (p < 0.0001), though it tends to overestimate values (mean difference: 3.35 kg). Among BIA equations, MMTalluri correlated best with CT (r = 0.834, p < 0.001). Compared to muscle ultrasound (US), BIA showed moderate correlation, though US was more sensitive in detecting early muscle loss. BIA-derived parameters like ECW/ICW ratio are linked to fluid overload and worse outcomes. BIA-guided nutrition improved intake and was associated with shorter ICU stays and reduced ventilation time, though not survival. Used with tools like NUTRIC or GLIM, BIA enhances nutritional assessment in CIP.

Conclusion: BIA is effectively identifies malnutrition and correlates with muscle mass and fluid status in CIP. Its use supports nutritional assessment, improves intake, and is linked to shorter ICU stays and ventilation time, highlighting its value in clinical practice

Disclosure of Interest: None declared