Phasenwinkel und Bioelektrische Impedanzvektoranalyse – Klinische Anwendbarkeit der Impedanzparameter

Zusammenfassung

Die Verwendung des Phasenwinkels und weiterer Rohwerte der Bioelektrischen Impedanzanalyse(BIA) hat als Alternative zur Berechnung der Körperzusammensetzung in den letzten Jahren zunehmend an Bedeutung gewonnen. Die vorliegende Arbeit gibt einen Überblick über die klinische Anwendbarkeit und Bedeutung von Phasenwinkel und Bioelektrischer Impedanzvektoranalyse (BIVA). Der Phasenwinkel berechnet sich direkt aus der Resistanz (Ohm'scher Widerstand) und Reaktanz (kapazitiver Widerstand). Zahlreiche Studien belegen, dass der Phasenwinkel bei verschiedensten Krankheitsbildern ein signifikanter Prädiktor der Mortalität ist. In der BIVA werden Resistanz und Reaktanz als bivariater Vektor grafisch in einem Koordinatensystem (Vektorgraph) dargestellt. Die Betrachtung der Vektorlage ermöglicht eine detaillierte Sicht auf Hydratationszustand bzw. Zellmasse und erlaubt somit die Beurteilung auch solcher Personen, bei denen aufgrund veränderter Hydratationszustände keine genauen Ergebnisse der Körperzusammensetzung zu erwarten sind. Referenzwerte, die die Interpretation der Daten ermöglichen, existieren sowohl für den Phasenwinkel als auch für die BIVA. Die Impedanzparameter sind für die klinische Verwendung geeignet, erlauben die Identifizierung von Risikopatienten und sind insbesondere dann für das Ernährungsassessment interessant, wenn eine valide Berechnung der Körperzusammensetzung nicht möglich ist.

Abstract

The use of phase angle and other raw parameter of the bioelectrical impedance analysis (BIA) has gained attention as an alternative to the assessment of body composition over the last years. This work gives an overview over the clinical use of phase angle and Bioelectrical Impedance Vector Analysis (BIVA). Phase angle is calculated directly from resistance (pure opposition of a biological conductor to alternating electric current) and reactance (capacitative resistance). Various studies show the prognostic value of phase angle in relation to mortality in different clinical settings. BIVA uses the plot of impedance parameters resistance and reactance normalized per height as a bivariate vector in the vectorgraph. The shortening or lengthening of the vector indicates hydration status in form of oedema or dehydration, respectively, whereas a migration sideways indicates increase or decrease in body cell mass. BIVA thus provides information about hydration status and body cell mass and therefore allows assessment of patients in whom the calculation of body composition fails due to altered hydration status. Reference values exist for both phase angle and BIVA, which facilitates interpretation of the data. Impedance parameters and phase angle are useful for clinical practice, allow the identification of risk patients and are relevant for nutritional assessment, in particular when calculation of body composition is not feasible.

Phasenwinkel - Bioelektrische Impedanzanalyse - Bioelektrische Impedanzvektoranalyse

phase angle - bioelectrical impedance analysis - Bioelectrical Impedance Vector Analysis

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