P624 - RETHINKING METABOLIC ASSESSMENT IN TRAUMA: THE EMERGING ROLE OF BIOELECTRICAL IMPEDANCE ANALYSIS

P624

RETHINKING METABOLIC ASSESSMENT IN TRAUMA: THE EMERGING ROLE OF BIOELECTRICAL IMPEDANCE ANALYSIS

R. Darie^1,2,*, C. Cobilinschi^1,3, A.-M. Cotae^1,3, A. C. Andrei¹, L. Lovin¹, I.-M. Grintescu^1,4, R. Tincu^1,2, R. Ungureanu^1,3, E. Moisa⁵, R. Ene⁶, L. Mirea^1,3

¹Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, ²Department of Clinical Toxicology, ³Department of Anesthesiology and Intensive Care II, ⁴Department of Anesthesiology and Intensive Care, Carol Davila University of Medicine and Pharmacy, ⁵Department of Anesthesiology and Intensive Care, Elias University Emergency Hospital, ⁶Orthopedics and Trauma Surgery, Clinical Emergency Hospital Bucharest, Bucharest, Romania

Rationale: The acute metabolic response in polytrauma patients is highly variable and difficult to predict using conventional trauma scoring systems. This study investigates the extent to which bioelectrical impedance analysis (BIA) offers enhanced insights into metabolic alterations.

Methods: A prospective observational study was carried out at the Clinical Emergency Hospital of Bucharest. Of the 123 patients initially screened, 36 polytrauma patients (80.6% male; mean Injury Severity Score [ISS] 41.1 ± 11.9) were enrolled in the study. Indirect calorimetry (IC) and BIA were performed to assess resting energy expenditure (REE), substrate utilization (RQ), and body composition. Correlations between metabolic parameters, trauma severity , and BIA-derived metrics were analyzed using Spearman’s rank and linear regression.

Results: No significant differences in indirect calorimetry or bioelectrical impedance analysis parameters were observed based on the type of injury or the total number of traumas (p > 0.05,ANOVA). REE showed strong positive correlations with several BIA-derived metrics: total body water (ρ=0.61,p = 0.003), intracellular water (ρ = 0.608,p = 0.003), extracellular water (ρ=0.597,p=0.003), and fat-free mass (ρ=0.604,p=0.003). Phase angle (PA) demonstrated a significant inverse correlation with urea levels (ρ = -0.469, p = 0.024) and body mass index (ρ = -0.577, p = 0.004). Linear regression analysis identified FFM as the strongest independent predictor of REE (R² = 0.27, p = 0.013), whereas PA was found to predict urea levels (R² = 0.22, p = 0.024). 

Conclusion: The acute metabolic response in polytrauma patients is poorly reflected by injury patterns or severity scores but is closely linked to BIA-derived body composition metrics. FFM, TBW, and PA emerge as superior predictors of energy expenditure and catabolic state, highlighting BIA’s potential for personalized nutritional and metabolic management.

Disclosure of Interest: None declared