Illness Marker & Dehydration Index | The Products | Bodystat

Bodystat® Illness MarkerTM

&

Dehydration Index

(Impedance Index for USA)
for
Clinical assessment
of
for
BODY CELL HEALTH STATUS
MONITORING of HYDRATION STATUS
and as a
in
PREDICTOR OF OUTCOME
COMPETETIVE ATHLETES
in seriously ill patients
Bluebook    
using  
   
BIA multi-frequency technology  
impedance values  
at 5 kHz and 200 kHz ONLY  
   
and  
   
independent of weight, age and sex.  

The Bodystat® QuadScan 4000 multi-frequency device measures Impedance values at 5, 50, 100 and 200 kHz.

The QuadScan 4000 is designed more for hospitalised patients (or trained athletes to check their hydration status) where a higher degree of measurement sensitivity is required (hence using 200 kHz) in tracking CHANGE of fluid shifts and cellular health. The Bodystat 1500MDD with its Wellness Marker only measures up to 50 kHz and would not be suitable for these subject groups.

Impedance is the resistance to the flow of the current in a given body. Hence the greater the resistance, the higher the Impedance measurement value.

In a healthy subject, at a low frequency of 5 kHz, the Impedance or resistance will be HIGH because the current cannot penetrate the cell membrane - it measures therefore only the extra-cellular space (ECW). A HIGH Impedance value is registered on the device.

However, at a higher frequency of 200 kHz, the current is sufficient to penetrate the cell membrane wall; the Impedance is then LOWER and measures both inside and outside the cells - total body water (TBW).

The greater the variance between these two values, the healthier the body cell.

Hence, if these two values are tracked over time (days, weeks) and the variance becomes smaller, this may indicate that the cell is becoming less healthy.

With the two impedance values expressed as a ratio of 200 kHz / 5 kHz, then the closer to 1.00, the less healthy the body cell.

NOTE: Some users express the ratio as 5 kHz divided by 200 kHz producing values greater than 1; this method still produces the same evidence, namely the closer to 1.00, the less healthy the body cell.

It appears from data analysis that for healthy people with good cellular nutritional status, we find this Marker or Indicator to be around 0.75 and for very fit people, even lower. In the case of critically ill subjects, with poor and deteriorating cellular status, this "Illness Marker" may increase to around 0.86 and higher.

As a subject approaches death, the ratio would therefore become even closer to 1.00.

Some investigators calculate the ratio as 5 kHz / 200 kHz (Refer VAL 29 below) and may use this Index as a PREDICTOR OF OUTCOME in seriously ill patients.

Healthy Male 51 yrs

Frequency Impedance
in Ohms
"Illness Marker" Phase Angle
at 50 kHz
Reactance
at 50 kHz
5 kHz 573
50 kHz 480 7.3° 61
100 kHz 450
200 kHz 433 0.756

Variance between
5 and 200 kHz
140

"Dying" Male 58 yrs

Frequency Impedance
in Ohms
"Illness Marker" Phase Angle
at 50 kHz
Reactance
at 50 kHz
5 kHz 568
50 kHz 530 2.9° 27
100 kHz 515
200 kHz 504 0.887

Variance between
5 and 200 kHz
64

TO EXPLAIN MORE FULLY

Expansion of ECW and loss of ICW are typical features of systemic illness and arises from protein leakage into the extra-cellular space and loss of intra-cellular protein in the case of critical illness.

Loss of intra-cellular potassium and extra-cellular accumulation of sodium result in an increased whole-body exchangeable Na+-K+ ratio, which is a strong predictor of mortality in surgical patients.

The resistance of the cell membrane at 5 kHz, is therefore significantly reduced in the case of critical illness and the difference between the Impedance values at 5 kHz and 200 kHz is markedly closer to each other, indicating cellular deterioration.

In the past, there have been many publications claiming that Phase Angle (PA) could be used as an indicator of survival times; the lower the PA, the shorter the survival time. It seems that healthy subjects have PA values of at least 6° and higher; subjects with 5° have lower survival times and below 4.4°, even lower survival times.

The phase angle is defined as the relation between the two vector components of impedance: resistance and reactance. It may be interpreted as an indicator of water distribution between the extra- and intra-cellular spaces.

However, it is not easy to explain nor to understand the concept of Phase Angle. Furthermore, BMI does not reflect nutritional status in ill patients, as the decrease in body cell mass is obscured by an expansion of extra-cellular water.

We have instead adopted the Bodystat "Illness Marker" approach using the index between Impedance values at the two above-mentioned frequencies. This approach therefore uses only factual raw data measurement and does require the use of the latest in multi-frequency electronic technology, hence the use of our Bodystat® QuadScan 4000 device. This approach is also easier to explain to clinicians and for others to understand.

Note that neither subject weight, gender, age, height nor race group, is required as input data. Either whole body or segmental analysis is possible. The test is furthermore, quick and easy to perform.

ADVANTAGES

  • Potential opportunity for use:
    • Predictor of Outcome or "Illness Marker"TM
    • Effectiveness of Rehabilitation recovery
    • Body Cell fitness
    • and
    • Hydrational Status assessment
  • No subject weight is required - often a problem in areas such as ICU
  • Independent of age and sex
  • Uses RAW IMPEDANCE DATA only - no predictive equations are required
  • Suitable for WHOLE BODY and SEGMENTAL analysis
  • Applies to ANY:
    • disease state or physical fitness state
    • age group
    • population group
  • Uses only the latest in Multi-Frequency BIA electronic equipment
  • Quick to perform the test requiring little or no skills
  • Inexpensive technology
  • Non-invasive
  • Cost effective

Supporting evidence can be found under the RESEARCH DIGEST.
Refer to:

VAL 4
Nutrition index determined by a portable multifrequency bioelectrical impedance analysis machine. (Keller W et al.)
GUT 1998; 42 (suppl 1).

VAL 16
The use of multiple frequency bioimpedance to assess fluid balance in critical illness. (Campbell IT et al.)
Proceedings of the Nutrition Society 53:62A

VAL 28
Comparation of the estimated phase angle for different bioimpedacia devices. (M. Cecília F. Assunção et al.)
Presentation June 2004 in Brazil by M. Cristina G. B. e Silva

VAL 29
Value of multifrequency bioelectrical impedance in assessing fluid disturbances in patients undergoing major abdominal surgery. (Itobi E et al)
Presentation September 2004 at the ESPEN Congress in Lisbon, Portugal.

VAL 38
Electrical Bio-Impedance Devices: Are they all rated the same? (Barbosa e Silva et al.)
Presented as an Abstract at the FELANPE Nutrition Congress in Montevideo, Uruguay on 7th November, 2005.

VAL 39
Impedance Ratio: new multi-frequency electrical Bio-impedance functional assessment parameter. (Barbosa e Silva et al)
Presented as an Abstract at the FELANPE Nutrition Congress in Montevideo, Uruguay on 7th November, 2005.

VAL 41
Impact of oedema on recovery after major abdominal surgery and potential value of multifrequency bioimpedance measurements. (Itobi E, Stroud M, Elia M)
Br J Surg. 2006 Mar; 93(3):354-61

VAL 42
Impedance ratio as a measure of water shifts. (De Lorenzo A et al)
Ann Nutr Metab 41 (1997): 22-28

VAL 43
Nutritional aspects of body water dislocations in postoperative and depleted patients. (D H Elwyn et al)
Ann Surg. 1975 July; 182(1): 76-85

VAL 59
Multi-Frequency Bioelectrical Impedance Analysis and Cellular Health in Mobile CKD Patients. (L Mason et al)
Journal of the American Society of Nephrology (JASN) 19:2008. Ref.PUB638

VAL 62
Razón de Impedancias: novo parmetro para evaluacin funcional a partir de Bioimpedancia elctrica multifrecuencial. (Barbosa e Silva et al)
Presented at FELANPE, November 2005

VAL 63
Bioelectrical Impedance Analysis of patients with Scleroderma as an indicator of severity and activity of the disease. (MD Arias Sylvia et al)
Paper presented at the 29 World Congress of Medicine at Buenos Aires, Argentina, September 2008

VAL 67
Illness Marker as a prognostic tool in intensive care unit: a prospective study. (Gonzalez MC et al)
Presented at the American Society for Parenteral and Enteral Nutrition, Nutrition Week Congress, New Orleans, USA, February 2009 & Journal of Parental and Enteral Nutrition; Volume 33, Number 2. March-April 2009. SP-10. Page219

VAL 69
Preliminary results for use of Illness Marker in heart failure patients. (Réka Kegyes Bozó et al)
Published at the ESPEN congress 2009

VAL 71
Multiple-frequency bioelectrical impedance analysis and quadriceps strength in COPD patients. (Shrikrishna D et al)
Presented as an Abstract at the British Thoracic Society (BTS) Winter Meeting in London, UK, 2-4 December 2010

VAL 86
Calf Bioimpedance Ratio Improves Dry Weight Assessment and Blood Pressure Control in Hemodialysis Patients. (Yi-Lun Zhou et al)
Am J Nephrol 2010;32:109-116.

VAL 91
Impedance ratio Z200/Z5 compared to phase angle at 50 kHz better predicts nutritional status and length of stay in hospitalized patients. (Earthman CP et al)
Published at the 9th International Symposium on In Vivo Body Composition Studies, Hangzhou, China.

VAL 92
An evaluation of phase angle, impedance ratio, and bioimpedance vector for assessing body composition and clinical outcomes in gastric bypass patients. (Earthman CP et al)
Published at the 9th International Symposium on In Vivo Body Composition Studies, Hangzhou, China.


GRAPHIC PRESENTATION

From the graphic presentation below, the curve of the "dying" male is much flatter than the healthy male; the steeper the curve the healthier the body cell.

Copyright © 2005, Bodystat Limited.