Abstract 808: Quantification of Water Loss with a Portable Bio-electrical Impedance Device in Patients with Acute Decompensated Heart Failure: A Pilot Study
Introduction: Quantification of water loss in patients admitted with Acute Decompensated Heart Failure (ADHF) provides useful information regarding the efficacy of therapeutic interventions. Outside the setting of a clinical trial, accurate measurement of fluid intake and output is sometimes difficult, especially in patients without a urinary catheter. Portable Bio-electrical Impedance (BIA) monitors for measurement of Total Body Water (TBW) have not been evaluated to quantify water loss in patients with ADHF.
Methods: In this study we measured changes in TBW with a portable BIA device in patients with ADHF to determine the feasibility of using this method to quantify water loss expected to occur in short periods of time as a result of therapeutic interventions. Patients admitted with ADHF with evidence of volume overload were included in the study. Fluid intake and output were carefully recorded. Weight and TBW were measured with a portable BIA monitor (TANITA® model: BC534) every 24 hours during hospital stay.
Results: Twelve patients were included. The average daily water loss in responders to diuretic therapy was 1,010+1,164 ml and the average TBW change per day was 2+2%. A change of 2.5% in TBW over 24 hours had a sensitivity of 75% and a specificity of 81% to identify patients with water loss higher than one liter in the same period. See figure⇓ for operating characteristics of the test.
Conclusions: Portable BIA is a promising noninvasive tool to monitor water loss in patients with ADHF undergoing treatment with diuretics. Further studies are needed to better determine the efficacy of this modality and its role in impacting management decisions and outcomes in patients with ADHF.