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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access originally published online on February 19, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009 64A(6):664-669; doi:10.1093/gerona/glp018
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Rapid Measurement of Total Body Water to Facilitate Clinical Decision Making in Hospitalized Elderly Patients

James S. Powers1,2, Leena Choi3, Rhonda Bitting1, Nitin Gupta1 and Maciej Buchowski1

1 Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
2 Tennessee Valley Geriatric Research Education and Clinical Center, Tennessee Valley Healthcare System, Nashville
3 Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee

Address correspondence to James S. Powers, MD, Department of Medicine, Vanderbilt University School of Medicine, 7155 Vanderbilt Medical Center East, Nashville, TN 37232. james.powers{at}vanderbilt.edu


  Abstract

Background: Bioelectrical impedance analysis (BIA) is a noninvasive rapid and simple bedside technique that can be used to predict total body water (TBW), extracellular water (ECW), and intracellular water (ICW) and identify altered fluid distribution following critical illness.

Methods: An equivalence study of BIA in 32 hospitalized elderly patients was compared with reference standard dilutional measurements of deuterated water (TBW) and sodium bromide (ECW). The results were compared with anthropometric equations commonly used to predict TBW.

Results: There was variability in TBW content among the participating hospitalized elderly patients. This variability was within (±5 L) and the percent difference between the standard and BIA was as follows: mean (range) –4.1% (–18.5 to 11.2). BIA reliably predicted TBW and ECW in individual participants, whereas standard prediction equations uniformly over- or underestimated TBW in individuals and whole group population.

Conclusion: TBW in hospitalized elderly patients can be estimated noninvasively by bedside BIA. Standardized anthropometric equations have to be used with caution in this population.

Keywords Total body water; Body composition in aging; Bioelectrical impedance

Received: August 11, 2008; Accepted: October 22, 2008

Decision Editor: Luigi Ferrucci, MD, PhD


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