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 estimate of R E from the curve-fitting routine was used as a marker of relative changes in fluid status during dialysis for comparisons between the five body segments, where the whole-body analysis models are not appropriate.
Body Composition Monitor
Healthy controls had height measured using a stadiometer and weight measured freseniua calibrated scales. The effect of vascular access modality on changes in fluid content in the arms as determined by freseniis bioimpedance.
This is supported by looking at the segmental impedance freseinus. Using the segmental resistances in table 4the different path resistances can be built from the segments and referenced to the standard path figure 3. In summary, these data helps BCM users make measurements and interpret results with greater confidence. There was good agreement between BCM-measured OH and change in weight, suggesting post-dialysis measurements can be utilised.
Assessing fluid change in hemodialysis: 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. Bland Altman analysis was done using Analyse-it for Microsoft Excel version 2.
Associated Data Supplementary Materials Appendices. The effect of utilising alternative measurement paths was assessed using mixed effects models and the effect of measuring post-dialysis was assessed by comparing changes in BCM-measured overhydration OH with weight changes over dialysis.
For the arm to arm path, the higher resistance of the arms seems to be compensated by a lower measured resistance for a current crossing the trunk from arm to arm than from arm to leg. To present the data, results for a 60 year old female measured on the standard path acted as a reference standard path was taken as hand-to-foot on gcm dominant fresemius of the body for controls and on and the contralateral side of the body to the most recently used vascular access VA for dialysis patients.
For haemodialysis patients, height was taken from their clinical notes and pre- and post-dialysis weights were obtained as part of normal care. Furthermore, the consistency of LTM and ATM from the start to end of dialysis was assessed based on the effect of measurement time in each of the mixed-effects models. Clinical journal of the American Society of Nephrology: Difference is relative to the dominant path. Haemodialysis patients showed different pre-dialysis patterns than subjects with normal renal function.
This would suggest that relatively more fluid is recruited from the legs than the upper body which is largely in agreement with previous work.
Adjustments for age and sex in each model are given and also for measurement time in the models assessing LTM and ATM. 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.
However, there is a lack of a sufficiently robust evidence-base for use of the BCM outside of standard protocols. There are reasonably large limits of agreement which should be taken into account when making post-dialysis measurements, but these measurements were taken immediately after dialysis and it is reasonable to assume that they would be reduced if there was a time delay introduced between dialysis end and BCM measurement, as recommended by the manufacturer.
Discussion Rationale for the need for flexible measurement protocols 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. For healthy controls, subject was frewenius as the random effect and path, sex and age were taken as fixed effects.
If relative changes in R E over dialysis are used to indicate changes in fluid status, it can be seen that the greatest relative change is in the leg segments table 5. Predicting body cell mass with bioimpedance by freseniuw theoretical methods: International Symposium on Home Hemodialysis.
Recruiting 48 subjects into each cohort would allow differences of 0.
BCM-measured OH is greater when measuring across a site of vascular access, but the fresfnius arguably is not clinically significant when the uncertainty in other freswnius of target weight assessment is considered.
If that is true, techniques for fluid management based on normalising calf ECF Seibert et al. Changing from a whole-body measurement to a hand-to-hand or cross measurement will involve substitution of one limb for another and a change in the pathway through the trunk.
Body composition monitor (BCM)
Yet there is a lack of data to support use of BCM bm this standardised approach and there remains a great deal of uncertainty in utilisation of the technology in certain individuals. Author information Copyright and License information Disclaimer. The 8-lead device does not display Cole-plots or body composition data to allow real-time assessment of artefacts or frwsenius, so repeat measurements were not made. BCM measurements were made in 48 healthy controls and in 48 stable haemodialysis patients before and immediately after dialysis.
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. However, in practice these requirements would exclude a relatively large number of patients from having BCM measurements. Segmental bioelectrical impedance analysis. Routine target weights were defined on the basis of clinical examination and BCM on indication.
Specifications of an 8-lead BCM measurement. Programmes were written in Matlab v.
Open in a separate window. Normal values for segmental bioimpedance spectroscopy in pediatric patients.
Body Composition Monitor
This provided equivalent data to the standard BCM device, which was validated by processing standard BCM impedance data with the custom analysis programme and comparing the results with those from the standard BCM see appendix 1.
These results suggest BCM protocols can be flexible regarding measurement paths and timing of measurement to dresenius as many patients as possible can benefit from the technology.
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.
Freseniuz 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. Table 2 Model for OH in healthy controls. Where accurate monitoring of body composition is important, the standard pathway is preferred and consistency is important. The only investigation to consider alternative paths frewenius BIS measurements was fresdnius preliminary work for this study, where it was shown that BCM-measured overhydration OH from the hand-to-hand path is an acceptable alternative to the standard path Keane and Lindley,