title: Bioelectrical impedance parameters in critically ill children: importance of reactance and resistance.
abstract: OBJECTIVE
  Currently, there are no clinical or laboratory parameters that can be used efficiently to predict the prognosis of critically ill patients, but in some situations, raw bioelectrical impedance parameters have been shown to be useful. The purpose of this study was to investigate the behavior of reactance and resistance in the severity of the critically ill pediatric patient.
  
  
  METHODS
  We prospectively analyzed bioelectrical impedance in a sample of 332 critically ill pediatric patients submitted to mechanical ventilation. The values taken on admission and discharge were correlated with major outcomes to the critically ill patient.
  
  
  RESULTS
  We found an association of low values of Xc/H (<27.7 Ohm/m) and of R/H (<563.6 Ohm/m) on admission with multiple organs dysfunction greater or equal to 4. Both R/H and Xc/H increased significantly between admission and discharge among survivors, while among nonsurvivors there was a trend of decrease between admission and the last measurement before death.
  
  
  CONCLUSIONS
  Bioelectrical impedance is a useful tool for monitoring of critically ill pediatric patients. A possible role of R/H and Xc/H, especially the latter, as a predictive biomarker of evolution for septic shock and organ dysfunction still remains to be elucidated.
authors: Intensive Care Unit, Pediatrics Department, Fernandes Figueira Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors: Zina Maria Almeida
authors: ZM
authors: Azevedo
authors: Daniella Campelo Batalha Cox
authors: DC
authors: Moore
authors: Flavia Aparecida Alves
authors: FA
authors: de Matos
authors: Vania Matos
authors: VM
authors: Fonseca
authors: Maria Virginia Marques
authors: MV
authors: Peixoto
authors: Maria Ignez C
authors: MI
authors: Gaspar-Elsas
authors: Erika
authors: E
authors: Santinoni
authors: Luiz Antonio
authors: LA
authors: Dos Anjos
authors: Eloane Gonçalves
authors: EG
authors: Ramos
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D000293:Adolescent; D015415:Biomarkers; D001823:Body Composition; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D019095:Point-of-Care Systems; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy
chemical_list: D015415:Biomarkers
keywords: Child; Critical illness; Electric impedance; Multiple organ failure; Sepsis