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bioimpedance vector analysis (BIVA)

Indications: - non-invasive, quick & inexpensive technique to estimate body composition, including total body water - evaluation of heart failure [1] - assessment of risk for contrast nephropathy [2] Principle: - fat-free tissues & fluids are good conductors, while bone & fat tissues are poor conductors - resistance is inversely related to the total body water Procedure: - measures the opposition of body tissues to the flow of an alternating current of 800 micro Amps at an operating frequency of 50 kHz (bioelectrical impedance - performed with a portable battery-operated device - subject must be supine with inferior limbs at 45 degrees & superior limbs abducted at 30 degrees to avoid skin contacts with the trunk and with stretcher - 4 cutaneous electrodes, 2 on wrist & 2 on ipsilateral ankle, are applied with an inter-electrode distance of at least 5 cm to prevent interaction between electrodes - bioelectrical impedance is measured in about 30 sec - reference values are adjusted for patient's age, BMI, gender & height - results are plotted resistance vs reactance* to provide a vector proportional to total body water * reactance (Xc) is considered proportional to body mass

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bioimpedance analysis

References

  1. Di Somma S, Vetrone F, Maisel AS Bioimpedance Vector Analysis (BIVA) for Diagnosis and Management of Acute Heart Failure. Curr Emerg Hosp Med Rep (2014) 2: 104 https://link.springer.com/article/10.1007/s40138-014-0043-9
  2. Maioli M et al. Bioimpedance-guided hydration for the prevention of contrast- induced kidney injury: The HYDRA Study. J Am Coll Cardiol 2018 Jun 26; 71:2880. PMID: 29929610 - Brar SS. Protocol-driven CI-AKI prevention in the cath lab. J Am Coll Cardiol 2018 Jun 26; 71:2890. PMID: 29929611