Fresenius Medical Care The BCM – Body Composition Monitor allows the detection of overhydration by determining the quantitative amount of excess fluid in. Fresenius Medical Care SUPPORT. For further information on the BCM – Body Composition Monitor, please see the following downloads: General Information. Download scientific diagram | The Fresenius’ Body Composition Monitor (BCM) is an example of multi-frequency Bio-impedance analysis technology. Picture.
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The only statistically significant interaction was for the foot-to-foot path, which suggests that there is a greater change in BCM-measured OH across this path compared to the other paths. Recruiting 48 subjects into each cohort would allow differences of 0.
Predicting body cell mass with bioimpedance by using theoretical methods: In principle the models that were generated and validated for the standard path can be employed with alternate bvm.
Bland Altman analysis was done using Analyse-it for Microsoft Excel version 2. Programmes were written in Matlab v. Current opinion in clinical nutrition and metabolic care. However, in practice these requirements would exclude a relatively large number of patients from having BCM measurements.
Body Composition Monitor
Difference is relative to the dominant path. Fluid shifts from the limbs into the trunk manifest as an apparent decrease in ECF when freeenius by whole-body techniques and shifts from the trunk to the limbs as an increase in ECF Lundvall et al.
The data from healthy controls show that there is no difference in BCM-measured OH between all the whole-body paths other than the foot-to-foot measurement, freseniuz had a difference of 0.
This supports the validation literature of the BCM which has shown that the change in BCM-measured OH over dialysis is comparable to the ultrafiltration volume Wabel et al. National Center for Biotechnology InformationU. The American journal of clinical nutrition.
Body composition monitor (BCM)
More recently, two studies from a single centre using segmental BIA SBIA have reported that water and lean tissue content is different in the fistula and non-fistula arms Panorchan et al. These results suggest BCM protocols can be flexible regarding measurement paths and timing of measurement to ensure as many patients as possible can benefit from the technology. Yet there is a lack of data to support use of BCM outside this standardised approach and there remains a great deal of uncertainty in utilisation of the technology in certain individuals.
Making BCM measurements post-dialysis introduces a negligible bias to OH measurements but does increase measurement uncertainty, which should be accounted for when interpreting such data.
A larger sample would allow better estimates of these different estimates. Supplementary Material Appendices Click here to view.
This is based on a number freseniue key observations:. This characterises the individual differences in fluid status and body composition and accounts for this when describing the differences between the paths at the cohort level. Abbas et al Abbas et al. The potential for the equivalence of impedance across different paths was demonstrated two decades ago using bioimpedance analysis BIA measurements Lukaski et al. The BCM validation literature also suggests that a bias is introduced into measurements of LTM and ATM when measurements are made immediately after dialysis but within 30 minutes freseius becomes non-significant.
All BCM measurements were checked visually for artefacts, and repeated until the difference in measured OH was no greater than 0. Changes in hydration following haemodialysis estimated with bioimpedance spectroscopy.
Bioimpedance measurements with the Body Composition Monitor BCM have been shown to improve fluid management in haemodialysis.
Body composition monitor Files
Bioimpedance-guided fluid management in hemodialysis patients. Rapid plasma volume decline upon quiet standing reflects large filtration capacity in dependent limbs. Measurements over the first 75 minutes of dialysis using BIS Shulman et al. Use of post-dialysis measurements Considering the use of post-dialysis BCM measurements, change in body weight was compared to change in BCM-measured OH as there is no accepted gold standard measure of OH to validate post-dialysis measurements.
Effect of change in fluid distribution in segments in hemodialysis patients at different ultrafiltration rates on accuracy of whole body bioimpedance measurement.
Using the segmental resistances in table 4the different path resistances can be built from the segments and referenced to the standard path figure 3. However, dialysis has been shown to perturb fluid distributions Shulman et al. This is deemed an acceptable sample size; differences below 0.
For these models, measurement time was included as a predictor variable to investigate the validity of post-dialysis measurements of LTM and ATM. By making 8-lead BCM measurements on healthy controls and dialysis patients, the effect of a number of simple alterations to BCM measurements are characterised which will allow these measurements to be made with greater confidence.
Body composition monitor (BCM)
Normal values for segmental bioimpedance spectroscopy in pediatric patients. The use of measurement time as an interaction term in the models for dialysis patients showed that measured-OH changed by a different amount between the paths.
Probing the dry weight by bioimpedance: This discrepancy seems likely to be due to artefactual BCM measurements and highlights the need for some expertise when making measurements Lindley et al.
However, there is a lack of a sufficiently robust evidence-base for use of the BCM outside of standard protocols. Table 4 Relative segmental resistances as a proportion of standard whole body path resistances. Validated alternative pathways would allow measurements to be made on patients who would have otherwise have been managed without BCM or managed based on poor quality data.
Significance levels were set at 0. Results Model results Patient characteristics can be seen in table 1. Bioimpedance-guided fluid management in maintenance hemodialysis: Biomed Phys Eng Express. Considering LTM and ATM, there was a significant difference between the reference path and most other paths, apart from the cross measurements, including higher LTM and lower ATM in the dominant arm and in the hand-to-hand path as compared to the reference path.
Body fluid volume determination via body composition spectroscopy in health and disease.
Measurements on healthy controls suggest there is no significant difference in OH from any whole-body path other than across the legs. The 8-lead device does not display Cole-plots or body composition data to allow real-time assessment of artefacts or consistency, so repeat measurements were not made. Estimation of RI has much greater uncertainty and for segmental measurements, especially, in the trunk, the data were largely uninformative.
This study aims to characterise BCM measurement variation to allow users to make measurements and interpret the results with confidence in a range of clinical scenarios. BCM-measured OH is greater when measuring across a site of vascular access, but the increase arguably is not clinically significant when the uncertainty in other methods of target weight assessment is considered. At a fresejius level, it is becoming well accepted that using BCM as an aide freseius guiding fluid management in haemodialysis improves outcomes Onofriescu et al.