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 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 this becomes non-significant.
bxm Probing the dry weight by bioimpedance: There was good agreement between BCM-measured OH and change in weight, suggesting post-dialysis measurements can be utilised. Normal values for segmental bioimpedance spectroscopy in pediatric patients.
Extracellular fluid redistribution during hemodialysis: Sum of segmental bioimpedance analysis during ultrafiltration and hemodialysis reduces sensitivity to changes in body position. Author manuscript; available in PMC May To investigate the validity of post-dialysis measurements, the agreement between change in BCM-measured OH from the reference path and change in weight was assessed using Bland-Altman analysis.
Measurements of resistance, reactance and phase angle were made at the same 50 frequencies as in the standard BCM, for seventeen combinations of voltage and current see fig.
Body composition monitor (BCM)
For measurements of R Esubstituting limbs and trunk paths does not significantly alter the overall path R Efor any of the whole body paths except the leg to leg path which is noticeably lower, consistent with results from the regression model. 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. One of the implications of preferential removal of fluid from the legs than arms could be that the legs are the last segment that fluid is recruited from.
Despite the good agreement between change in BCM-measured OH freseniis change in weight, the model for OH did suggest there was a degree of ultrafiltration induced changes in fluid distribution, with a larger change in the lower limbs than the upper. Current opinion in clinical nutrition and metabolic care. BCM measurements were made in 48 cresenius controls and in 48 stable haemodialysis patients before and immediately after dialysis.
This is related to the effect that ultrafiltration Abbas et al. However, there are few pragmatic studies that can help to inform the use of BCM outside of the strict protocol recommended for measurements and used in interventional studies, which can exclude a significant number of patients when BCM is used as part of routine care.
For haemodialysis patients, height was taken from their clinical notes and pre- and post-dialysis weights were obtained as part of normal care. At a population level, it is becoming well accepted that using BCM as an aide in guiding fluid management in haemodialysis improves outcomes Onofriescu et al.
This provided equivalent data to the standard BCM device, which was validated by processing standard BCM impedance data with bcn custom analysis programme and comparing the results with those from the standard BCM see appendix 1.
Freseniks Center Support Center. All BCM measurements were fresenihs visually for artefacts, and repeated until the difference in measured OH was no greater than 0. This is consistent with previous work using BIA on controls that demonstrated decreased resistance in the dominant arm compared to the non-dominant arm Bedogni et al.
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Body composition monitor Files
Heavily bandaged limbs, damaged skin and amputations can prevent the use of the standard measurement path, while some complications may not prevent a measurement but will significantly affect the quality of the measurement — e. Bland Altman analysis was done using Analyse-it for Microsoft Excel version 2. A larger sample would allow better estimates of freseenius different estimates. Haemodialysis patients showed different pre-dialysis patterns than subjects with normal renal function.
Body composition monitor (BCM)
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.
Any of the whole body paths other than foot-to-foot can be used as an alternative to the standard path for measurement of OH, with an acknowledgement of the additional uncertainty when interpreting the results.
Clinical nutrition Edinburgh, Scotland ; 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, which had a difference of 0.
Measurements on healthy controls suggest there is no significant difference in OH from any whole-body path other than across the legs. Use of alternate paths 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, which had a difference of 0.
Routine target weights were defined on the basis of clinical examination and BCM on indication. Sample size Pilot work comparing BCM measurements from hand-to-hand and from hand-to-foot showed standard deviations of the mean difference in OH of around 1. To examine each model, plots of standardised residuals against fitted values were used to check the assumption of homoscedasticity and a Q-Q plot of the residuals was used to assess normality.
Mixed-effects regression model The use of mixed-effects frrsenius allowed a model to be built that could account for frseenius repeated measures on an individual from the 8-lead BCM.
Dialysis patients showed fresenisu results other than having higher BCM-measured OH fresenis measured across the site of a vascular access. Considering the model results for LTM and ATM in controls, it is important to note that the equivalence of OH across different paths does not translate to these freseniue.
Programmes were written in Matlab v. Changes in hydration following haemodialysis estimated with bioimpedance spectroscopy. Supplementary Material Appendices Click here to view. Bioimpedance-guided fluid management in maintenance hemodialysis: Bland Altman analysis of the agreement of change in weight and change in OH. Comorbidities present included acute coronary syndrome, heart failure, cerebrovascular disease, liver disease, peripheral vascular disease and smoking.
Methods Subjects Ethical approval was granted by a local ethics committee and all participants provided informed consent. National Center for Biotechnology InformationU. 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.
It would also have been interesting to extend the analysis to a group of freseius patients who are defined as being prone to intradialytic hypotension IDHto investigate the relationship between fluid distributions, fluid dynamics and IDH.
Calf bioimpedance spectroscopy for determination of dry weight in hemodialysis patients: Associated Data Supplementary Materials Appendices. Journal of Applied Physiology. Specifications of an 8-lead BCM measurement. Ethical approval was granted by a local ethics committee and all participants provided informed consent.