title: Measurement of extracellular fluid volume in the neonate using multiple frequency bio-impedance analysis.
abstract: Bioelectrical impedance analysis may be useful for cot-side monitoring of fluid balance in the neonatal intensive care unit (NICU). However the presence of cardio-respiratory monitoring equipment, non-ideal electrode placement and inability to obtain accurate crown-heel measurements may interfere with the ability to obtain reliable impedance data in this setting. This study aimed to investigate the effects of these factors on impedance analysis and to develop a prediction equation for extracellular fluid volume in the neonate. The study found that cardio respiratory monitoring had no significant effect on multi-frequency impedance measurements. Placement of current delivering electrodes on the ventral rather than dorsal surfaces improved separation of current and voltage electrodes but did not alter impedance results. Contralateral measurements were not significantly different to ipsilateral measurements. In 24 infants, extracellular fluid volume was measured using corrected bromide space (CBS) and simultaneous impedance analysis was performed. There was good correlation between CBS and the impedance quotient FF2/Ro where F is foot length and R0 is resistance at zero frequency. The study concludes that despite many potential difficulties associated with impedance analysis in the NICU, reliable measurements of impedance can be obtained and further work to validate prediction equations for ECF is warranted.
authors.affiliation: Perinatal Research Centre, University of Queensland, Royal Women's Hospital Brisbane, Australia. lingwoodb@health.qld.gov.au
authors.forename: B E
authors.initials: BE
authors.lastname: Lingwood
authors.forename: J P
authors.initials: JP
authors.lastname: Coghlan
authors.forename: L C
authors.initials: LC
authors.lastname: Ward
authors.forename: B G
authors.initials: BG
authors.lastname: Charles
authors.forename: P B
authors.initials: PB
authors.lastname: Colditz
mesh_terms: D017097:Electric Impedance; D004566:Electrodes; D005110:Extracellular Space / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D016014:Linear Models; D008991:Monitoring, Physiologic / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D014882:Water-Electrolyte Balance / Q000502:physiology*