Previously submitted to: JMIR Cardio (no longer under consideration since Mar 18, 2019)
Date Submitted: Aug 22, 2018
Open Peer Review Period: Aug 22, 2018 - Aug 31, 2018
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Utilization of Bioimpedance Spectroscopy in lieu of Invasive Monitoring for Monitoring Fluid Overload
Background:
Congestive heart failure (CHF) has become one of the most common diagnoses and a leading cost concern for Medicare and insurance companies. The majority of costs associated with CHF surround hospitalization and re-admissions. As a result of these rising costs, there has been a push to identify early markers of impending congestion as a surveillance tool and possible measure of effectiveness of treatment
Objective:
The measurement of diastolic pulmonary artery (PA) pressure from invasive devices has been shown to be useful in the management of New York Heart Association (NYHA) class III heart failure (HF) patients. It has been suggested that bioimpedance spectroscopy (BIS) could be used as a surrogate for volume overload, offering a non-invasive option for patients.
Methods:
We present a case of a NYHA class III HF patient with end stage liver disease. The patient had previously been implanted with a CardioMEMS device. Over several weeks, diastolic PA pressures and weight were compared to BIS measures from a SOZO, (noninvasive fluid monitoring system).
Results:
The use of BIS to estimate extracellular fluid accumulation shows excellent correlation to both diastolic PA pressure and weight, suggesting a use for non-invasive monitoring.
Conclusions:
Data from this case demonstrates the BIS correlates well with diastolic PA pressure. Because diastolic PA pressures from invasive devices are recognized as a way to prevent CHF hospitalizations, we postulate that BIS may potentially provide a surrogate, noninvasive method and therefore, may prove a useful adjunct in the management of HF.
ClinicalTrial:
IRB approval was obtained for this study (Scripps IRB #IRB-16-6852).
Citation
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