Relation Between Bioelectrical Impedance Analysis (BIA) and CT-scan Analysis in the ICU (ICUBIACT)

Relation Between Bioelectrical Impedance-derived Muscle Mass and CT-derived Muscle Area in Critically Ill Patients

Aim of the present study is to determine whether muscle mass as assessed by bioelectrical impedance analysis correlates with and corresponds to muscle mass as assessed by CT scan analysis in critically patients admitted to the intensive care unit.

Study Overview

• Status: Completed
• Conditions: Muscular Atrophy
• Intervention / Treatment: Other: BIA

Detailed Description

BIA measurements are performed in critically ill patients admitted to the ICU or MC, within 72 hours before or after CT scanning.

The BIA measurements are taken with the BIA 101 ASE, manufactured by Akern, Florence-7 Italy. This device is phase sensitive and injects an alternating current of 400 µA at 50 kHz. Measurements were performed while patients lay in supine position with a pillow supporting the head. The resistance, reactance, body weight and length are entered in the BIA algorithm, using BodyGram PRO. This algorithm calculated the body composition, with muscle mass being reported in kilogram (kg).

Abdominal CT scans are analyzed using the computer program SliceOmatic® version 4.3 and 5.0 (TomoVision, Montreal, QC, Canada) at the level of the third lumbar vertebra (L3). The muscle tissue was identified by using boundaries in Hounsfield Units (grayscale) set of -29 to +150(23). The program computes muscle surface area in cm2, by multiplying the pixel area by the amount of pixels identified as muscle.

For a direct comparison with the BIA-derived muscle mass, the CT-derived muscle area is converted to kg. This is done by following two steps. Firstly, the Shen equation is used for the conversion to litres.Secondly, the muscle volume is multiplied by its density, resulting in muscle mass expressed in kg.

• Study Type: Observational
• Enrollment (Actual): 222

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients admitted to the Adult Intensive Care Unit

Description

Inclusion Criteria:

• Abdominal CT-scan made for diagnostic reasons

Exclusion Criteria:

• CT-scan not analysable
• Internal or external metal devices
• active pacemaker

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
BIA and CT; Patients who had a CT-scan made for diagnostic reasons.	Other: BIA; Bioelectrical impedance analysis was performed within 4 days after a CT-scan was made; Other Names: Bioelectrical impedance analysis

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Agreement between BIA-derived muscle mass and CT-derived muscle mass	Agreement will be calculated using a Bland-Altman plot	Patient's data from the ICU-stay will be used, an average of one week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensitivity of BIA to identify low muscle patients	Using CT-derived cut-off points, sensitivity of BIA to identify the same patients as having low muscle will be calculated	Patient's data from the ICU-stay will be used, an average of one week
Specificity of BIA to identify low muscle patients	Using CT-derived cut-off points, specificity of BIA to identify the same patients as having low muscle will be calculated	Patient's data from the ICU-stay will be used, an average of one week
Correlation between BIA-derived muscle mass and CT-derived muscle mass	Correlation will be calculated using Pearson's r	Patient's data from the ICU-stay will be used, an average of one week

Collaborators and Investigators

• Sponsor: Amsterdam UMC, location VUmc
• Investigators: Principal Investigator: Wilhelmus Looijaard, MD, Amsterdam UMC, location VUmc

Publications and helpful links

General Publications

• Weijs PJ, Looijaard WG, Dekker IM, Stapel SN, Girbes AR, Oudemans-van Straaten HM, Beishuizen A. Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Crit Care. 2014 Jan 13;18(2):R12. doi: 10.1186/cc13189.
• Looijaard WGPM, Stapel SN, Dekker IM, Rusticus H, Remmelzwaal S, Girbes ARJ, Weijs PJM, Oudemans-van Straaten HM. Identifying critically ill patients with low muscle mass: Agreement between bioelectrical impedance analysis and computed tomography. Clin Nutr. 2020 Jun;39(6):1809-1817. doi: 10.1016/j.clnu.2019.07.020. Epub 2019 Aug 10.

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (Actual): May 1, 2015
• Study Completion (Actual): August 1, 2015

Study Registration Dates

• First Submitted: September 17, 2015
• First Submitted That Met QC Criteria: September 18, 2015
• First Posted (Estimate): September 21, 2015

Study Record Updates

• Last Update Posted (Estimate): May 11, 2016
• Last Update Submitted That Met QC Criteria: May 9, 2016
• Last Verified: May 1, 2016

More Information

Terms related to this study

• Keywords: Tomography, X-Ray Computed; Intensive Care; Muscles; Electric Impedance
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Neuromuscular Manifestations; Pathological Conditions, Anatomical; Atrophy; Muscular Atrophy
• Other Study ID Numbers: ICUBIACT

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No