title: Noninvasive assessment of extracellular and intracellular dehydration in healthy humans using the resistance-reactance-score graph method.
abstract: BACKGROUND
  Few dehydration assessment measures provide accurate information; most are based on reference change values and very few are diagnostically accurate from a single observation or measure. Bioelectrical impedance may lack the precision to detect common forms of dehydration in healthy individuals. Limitations in bioimpedance may be addressed by a unique resistance-reactance (RXc)-score graph method, which transforms vector components into z scores for use with any impedance analyzer in any population.
  
  
  OBJECTIVE
  We tested whether the RXc-score graph method provides accurate single or serial assessments of dehydration when compared with gold-standard measures of total body water by using stable isotope dilution (deuterium oxide) combined with body-weight changes.
  
  
  METHODS
  We retrospectively analyzed data from a previous study in which 9 healthy young men participated in 3 trials: euhydration (EUH), extracellular dehydration (ED; via a diuretic), and intracellular dehydration (ID; via exercise in the heat).
  
  
  RESULTS
  Participants lost 4-5% of their body weight during the dehydration trials; volume loss was similar between trials (ID compared with ED group: 3.5 ± 0.8 compared with 3.0 ± 0.6 L; P > 0.05). Despite significant losses of body water, most RXc vector scores for ED and ID groups were classified as "normal" (within the 75% population tolerance ellipse). However, directional displacement of vectors was consistent with loss of volume in both ED and ID conditions compared with the EUH condition and tended to be longer in ED than in ID conditions (P = 0.054).
  
  
  CONCLUSIONS
  We conclude that, whereas individual RXc-score graph values do not provide accurate detection of dehydration from single measurements, directional changes in vector values from serial measurements are consistent with fluid loss for both ED and ID conditions. The RXc-score graph method may therefore alert clinicians to changes in hydration state, which may bolster the interpretation of other recognized change measures of hydration.
authors: US Army Research Institute of Environmental Medicine, Natick, MA.
authors: Kristen R
authors: KR
authors: Heavens
authors: US Army Research Institute of Environmental Medicine, Natick, MA.
authors: Nisha
authors: N
authors: Charkoudian
authors: US Army Research Institute of Environmental Medicine, Natick, MA.
authors: Catherine
authors: C
authors: O'Brien
authors: US Army Research Institute of Environmental Medicine, Natick, MA.
authors: Robert W
authors: RW
authors: Kenefick
authors: US Army Research Institute of Environmental Medicine, Natick, MA samuel.n.cheuvront.civ@mail.mil.
authors: Samuel N
authors: SN
authors: Cheuvront
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D001834:Body Water; D001835:Body Weight; D003681:Dehydration / Q000175:diagnosis* / Q000378:metabolism; D017097:Electric Impedance; D006801:Humans; D008297:Male; D012016:Reference Values; D014882:Water-Electrolyte Balance; D055815:Young Adult
keywords: BIVA; hydration assessment; hypohydration; hypovolemia; volume depletion