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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When considering post-dialysis measurements, it is accepted that haemodialysis induced changes in fluid distributions affect whole-body bioimpedance Zhu et al. 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.
Significance levels were set at 0. Bioimpedance-guided fluid management in maintenance hemodialysis: Measurements of resistance, reactance and phase angle were made at the same 50 frequencies freseniu in the standard BCM, for seventeen combinations of voltage and current see fig. Predicting body cell mass with bioimpedance by using theoretical methods: 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)
The effect of utilising alternative measurement paths was assessed using mixed effects models and the effect of measuring post-dialysis was assessed by comparing dresenius in BCM-measured overhydration OH with weight changes over dialysis.
The data from healthy controls bcmm that there is no difference in BCM-measured OH between all the whole-body paths other than the foot-to-foot measurement.
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. 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. Bc fluid management in hemodialysis patients. All BCM measurements were checked visually for artefacts, and repeated until the difference in measured OH was no greater than 0.
To investigate the validity of post-dialysis measurements, the agreement between change in BCM-measured Fresfnius from the reference path and change in weight was assessed using Bland-Altman analysis.
This is based on fdesenius number of key observations: Author information Copyright and License information Disclaimer. Difference is relative to the non-VA side. For haemodialysis patients, height was taken from their clinical notes and pre- and post-dialysis weights were obtained as part of normal care.
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.
Bioimpedance measurements with the Body Composition Monitor BCM have been shown to improve fluid management in haemodialysis. 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.
Adjustments for age and sex in each model are given and fresemius for measurement time freseniud the models assessing LTM and ATM. Bland Altman analysis of the agreement of change in weight and change in OH.
Rapid plasma volume decline upon quiet standing reflects large filtration capacity in dependent limbs. Patient characteristics can be seen in table 1.
Body Composition Monitor
Measurements should also be made from hand-to-foot — as this is the only validated measurement path — and should avoid peripheral access sites, due to the presence fresehius anatomical changes. However, neither BIA or SBIA can adequately distinguish excess fluid from lean and adipose tissue, which left the possibility that the differences observed relate to differences in lean tissue alone rather than excess fluid, particularly given that fistulae tend to be placed in the non-dominant arm of patients.
Fluid management is an important part of care for haemodialysis patients Wizemann et ffesenius. Bioelectrical impedance analysis–part I: This is based on a number of key observations:. Conclusions In summary, these data helps BCM users make measurements and interpret results with greater confidence. Results Model results Patient characteristics can be seen in table 1.
This study aims to characterise BCM measurement variation to allow users freseniud make measurements and interpret the results with confidence in a range frfsenius clinical scenarios. In particular, there was a significant difference in pre-dialysis BCM-measured OH between the side of the body where vascular access was situated as compared to the contralateral side 0. The use of mixed-effects regression allowed a model to be built that could account for the repeated measures on an individual from the 8-lead BCM.
Difference is relative to the dominant path. Associated Data Supplementary Materials Appendices.
Abbas et al Abbas et al. 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.
Body composition monitor Files
The results here confirm that the presence of a vascular access does tend to increase OH. This would suggest that relatively more fluid is recruited from the legs than the upper body which is largely in agreement with previous work. There is growing evidence that the use of bioimpedance measurements with the body composition monitor BCM; Fresenius Medical Care, Germany can help guide fluid management and improve outcomes Moissl et al.
American journal of kidney diseases: The only investigation to consider alternative paths with BIS measurements was in 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, 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.
Haemodialysis patients showed different pre-dialysis patterns than subjects with normal renal function. 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.