中国体外生命支持2025，Vol.23Issue(6)：483-489,7.DOI:10.13498/j.cnki.chin.j.ecls.2025.06.03
体外循环期生物电阻抗相位角变化与心脏术后ICU住院时间的相关性研究
Correlation Between Changes in Bioelectrical Impedance Phase Angle During Cardiopulmonary Bypass and ICU Length of Stay After Cardiac Surgery
CAO Lu 1LI Yonghua 1MO Shaoyan 1XIAO Jiefei 1WU Xiaomei 1JIANG Yumei 1RONG Jian1
作者信息
- 1. Department of Extracorporeal Circulation,First Affiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong 510080,China
- 折叠
摘要
Abstract
Objective This study aimed to investigate the dynamic changes in bioelectrical impedance phase angle(PhA)during the peri-cardiopulmonary bypass(CPB)period and its predictive value for ICU length of stay(LOS)following cardiac surgery.Methods Sixty patients undergoing CPB cardiac surgery between May and July 2023 were prospectively en-rolled.Whole-body and segmental PhA and edema index(EI)were measured using a multifrequency bioelectrical impedance analyzer(InBody S10)pre-CPB(post-anesthesia)and post-CPB.Patients were stratified into low-PhA(≤5.85°,n=30)and high-PhA(>5.85°,n=30)groups based on preoperative PhA median.Intergroup comparisons of baseline characteristics,intra-operative parameters,and clinical outcomes were performed.Linear regression identified independent predictors of ICU LOS.Results Post-CPB PhA decreased significantly compared with pre-CPB values(5.46°±1.16° vs.5.85°±1.05°,P=0.0035),with elevated upper-limb EI(P<0.05).The low PhA group exhibited poorer baseline status:lower BMI(21.34±3.47 kg/m2 vs.23.80±3.12 kg/m2),reduced preoperative albumin(36.93±3.35 g/L vs.39.63±4.25 g/L),and higher APACHEⅡ scores(7.70±4.16 vs.4.93±2.18)(all P<0.01).This group required higher intraoperative RBC transfusion[3.2(2.0-4.0)U vs.2.0(0.0-2.9)U,P=0.029],prolonged mechanical ventilation[10.8(7.2-21.5)h vs.7.5(5.0-10.0)h],and extended ICU LOS[32.0(21.2-67.0)h vs.21.0(19.2-24.0)h](all P<0.05).Linear regression identified preoperative PhA(β=-39.48,95%CI:-68.05 to-10.92,P=0.009),intraoperative fluid balance(β=0.02,95%CI:0.01-0.04,P=0.047),and mechanical ventilation du-ration(β=0.90,95%CI:0.72-1.09,P<0.001)as independent predictors of ICU LOS.Each 1° increase in preoperative PhA was associated with a reduction in ICU LOS of 39.48 hours.Conclusion Significant reduction in PhA and increased upper-limb hy-dration during CPB suggest CPB-induced cellular membrane dysfunction and regional fluid redistribution.Preoperative low PhA independently predicts prolonged postoperative ICU LOS.Segmental bioelectrical impedance analysis of the upper limbs may serve as a targeted monitoring metric for goal-directed fluid management during CPB.关键词
生物电阻抗分析/相位角/水肿指数/液体平衡/重症监护病房住院时间/心脏手术Key words
bioimpedance analysis/phase angle/oedema index/fluid balance/ICU stay/cardiac surgery引用本文复制引用
CAO Lu,LI Yonghua,MO Shaoyan,XIAO Jiefei,WU Xiaomei,JIANG Yumei,RONG Jian..体外循环期生物电阻抗相位角变化与心脏术后ICU住院时间的相关性研究[J].中国体外生命支持,2025,23(6):483-489,7.
