PP465 - BIOELECTRICAL PHASE ANGLE AS AN INDICATOR OF CATABOLIC RESPONSE IN PATIENTS WITH SEVERE TRAUMA AND TRAUMATIC BRAIN INJURY

PP465

BIOELECTRICAL PHASE ANGLE AS AN INDICATOR OF CATABOLIC RESPONSE IN PATIENTS WITH SEVERE TRAUMA AND TRAUMATIC BRAIN INJURY

D. C. Meca^1,2,*, C. Cobilinschi^1,3, V. C. Zeca¹, D. Iacob^1,3, R. Darie^2,4, A.-M. Dumitriu^1,3, D. Ene^5,6, I. M. Grintescu^1,3, L. Mirea^1,3, C. Turculet^5,6

¹Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, ²Discipline of Clincal Toxicology, ³Discipline of Anesthesia and ICU - II, Carol Davila University of Medicine and Pharmacy, ⁴Department of Anesthesiology and Intensive Care II, ⁵Department of Surgery, Clinical Emergency Hospital of Bucharest, ⁶Discipline of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Rationale: In severe trauma, nutritional support targets caloric and protein goals, yet expected metabolic responses are not consistently observed despite  adequacy of prescription, suggesting a discrepancy between delivery and cellular utilization. Phase angle (PhA), a parameter derived from bioelectrical impedance analysis and a marker of cellular integrity, may capture this otherwise unrecognized dysfunction ^[1,2]. We evaluated whether PhA identifies the impact of metabolic support despite adequate nutritional delivery and its association with clinical outcomes.

Methods: Prospective cohort study of 25 patients with severe trauma (ISS ≥34) and TBI, mechanical ventilated for >48 h, with controlled shock, receiving standard enteral formula. Early ICU bioimpedance assessed PhA, stratifying patients independent of prescription. Outcomes included fat-free mass (FFM) loss, infection rate, mechanical ventilation duration (MV-days) and ICU length of stay (ICU-LOS).^[1]

Results: Despite standardized nutritional support, patients with lower PhA values reflected underlying impairment in cellular integrity. Patients with PhA ≤4.5°^[3] (n=12) showed greater FFM depletion, higher infection rates (~70–80% vs ~40–50%), longer MV-days (~20 vs ~10–15 days) and prolonged ICU stay (~40–50 vs ~25–35 days) compared to those with higher PhA (n=13), despite standardized nutritional support. Higher PhA may reflect preserved intracellular hydration and more effective nutrient utilization.^[4]

Conclusion: PhA may reveal a dissociation between delivery and response and enable real-time optimization of nutrition in line with ESPEN precision principles.

References: [1] da Silva TK et al. Clin Nutr. 2022  [2] Pérez Camargo DA et al. Clin Nutr. 2023 [3] Xu Y et al. BMC Nephrol. 2023 [4] Marra M et al. Nutrients. 2023

Disclosure of Interest: None declared