Chest Infections: Chest Infections |

Electrical Tissue Conductivity Can Reliably Predict Nutritional Status and Survival in Intensive Care Patients Admitted With Community-Acquired Pneumonia FREE TO VIEW

Alai Taggu, DM; Sreedhar Reddy, MD; Jerry Thomas, MD; MV Pradeep Arun, MD
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St. Johns Medical College Hospital, Bangalore, India

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A84. doi:10.1016/j.chest.2016.02.089
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: The aim of the study was to study the prognostic relevance of bioimpedance electrical analysis (BIA) derived parameters, of total leucocyte count and of serum albumin as indicators of nutritional status of patients in a mixed ICU

METHODS: Forty four ICU patients with community acquired pneumonia (CAP) admitted in the mixed ICU of a tertiary level South Indian Hospital between 2012 August to March 2013 were considered. After informed consent, all patients > 18years were included. Exclusion criteria were pregnancy, amputees, Body mass Index > 34 and < 16 Kg/m2, those with cardiac pacemakers and ascites. Baseline demographics, clinical, biochemical and BIA data were recorded. Based on serum albumin (SA) and total lymphocyte count (TLC), three nutritional status groups were formed. A model was created with with 3 covariates (TLC, Serum Albumin and phase angle), the prognostic impact of the TLC count and serum albumin was lower compared with the phase angle alpha.

RESULTS: Thirteen patients (30%) died from multi-organ failure during this period. Among 6 parameters estimated with a semiparametric Cox regression model adjusted for therapy (Ceftriaxone sodium, Azithromycin), the phase angle alpha (parameter estimate: -1.021, 95% confidence interval of -0.43 to -1.26; p < or = 0.0001), the ECM/BCM ratio, Xc, BCM, serum albumin, and TLC had significant prognostic influence on survival, whereas age, body weight, body mass index, resistance, serum protein, and serum triglycerides did not. In a model with 3 covariates (TLC, Serum albumin and phase angle), the prognostic impact of the TLC (parameter estimate: -0.431) was lower compared with the phase angle alpha (parameter estimate: -0.657; p < or = 0.0001) and did not gain statistical significance (p = 0.06). The phase angle alpha was the best single predictive factor for survival among all parameters (comparison of the respective Cox models with the likelihood ratio test)

CONCLUSIONS: Electrical tissue conductivity as measured by BIA can reliably predict survival in intensive care patients with CAP.

CLINICAL IMPLICATIONS: Use of BIA in ICU patients admitted with CAP is a reliable predictor of survival and nutritional status.

DISCLOSURE: The following authors have nothing to disclose: Alai Taggu, Sreedhar Reddy, Jerry Thomas, MV Pradeep Arun

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