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PP161-SUN: The Bioimpedance Vector Analysis (BIVA) for the Assessment of Muscle Mass and Function in Patients on Home Parenteral Nutrition (HPN) for Chronic Intestinal Failure
S80 and 529 normal children (271 males, 258 females; age, 7 12 years). CC, FL, height and weight were measured annually. Correlation coefficients were obtained between FL and height, and CC and BMI using the Gross Motor Function Classification System (GMFCS). Results: Correlation coefficients for FL and height were 0.911 in males and 0.866 in females with disabilities. According to the GMFCS, the correlation coefficients were as follows in males and females: I, 0.912 and 0.862; II, 0.953 and 0.895; III, 0.923 and 0.862; IV, 0.900 and 0.927; V, 0.962 and 0.793, respectively. The correlation coefficients for CC and BMI were 0.884 in males and 0.879 in females with disabilities. According to the GMFCS, the correlation coefficients were as follows in males and females: I, 0.859 and 0.864; II, 0.812 and 0.850; III, 0.858 and 0.854; IV, 0.874 and 0.858; V, 0.934 and 0.749. In the normal children, the correlation coefficients for CC and BMI were 0.817 in males and 0.814 in females. Conclusion: We found that in children and adolescents (handicapped or normal), CC and BMI, and FL and height are highly correlated. We can use this BMI derived from CC as Kaup Index and Rohrer Index from CC and FL as weight divided by the cube of height for them as a nutritional index. Disclosure of Interest: None Declared.
PP161-SUN THE BIOIMPEDANCE VECTOR ANALYSIS (BIVA) FOR THE ASSESSMENT OF MUSCLE MASS AND FUNCTION IN PATIENTS ON HOME PARENTERAL NUTRITION (HPN) FOR CHRONIC INTESTINAL FAILURE M. Guidetti1 , C. Pazzeschi1 , F. Agostini1 , R. Petitto1 , L. Pironi1 . 1 Center for Chronic Intestinal Failure, University of Bologna, Bologna, Italy Rationale: BIVA method for assessment of body composition is based on the impedance components, resistance and reactance, standardized for subject height and plotted as bivariate vector on a cartesian plane (the R-Xc graph-method). We evaluated the accuracy of BIVA for the assessment of muscle mass and function in HPN patients. Methods: A cross sectional study was performed in 53 adult patients, on HPN 6 months, PN infusions/week 3 week, for benign disease (25M/28F, age: 48±17/48±13 yrs). Impedance measurement: alternating current of 800 mA, 50 kHz. The skeletal Muscle Mass Index (SMI; kg/h2 ) was used to categorize the patients as normal or low muscle mass on the basis of measurements of appendicular skeletal lean mass by dualenergy x-ray absorptiometry (DEXA). Muscle function was assessed by hand grip strength (HGS; kg). Muscle Mass and Function: based on SMI and HGS values, subjects were categorized as: Normal (N; normal SMI and HGS), pre-sarcopenic (PS; ↓SMI, normal HGS), sarcopenic (S: ↓SMI and HGS). Statistics: Hotelling T2 tests. Results: Mean BIVA vector of patients with SMI lower than normal was sloped down than vector of those with normal SMI (M, p = 0.038; F, p = 0.021). In both genders, the mean vector becomes progressively longer and sloping down moving from N to PS and from PS to S (Males, N vs S: p = 0.007, PS vs S: p = 0.026; Females, N vs S: p = 0.008), and the mean vector of N and PS was placed in the area of normality of the R-Xc graph, whereas that of S was in the region of leanness.
Poster presentations Conclusion: The results support the accuracy of BIVA for the assessment of both mass and muscle function in patients on long-term HPN. Disclosure of Interest: None Declared.
PP162-SUN EVALUATION OF NUTRITION SUPPORT IN ICU PATIENTS WITH SPONTANEOUS INTRACRANIAL HEMORRHAGE P. Koukiasa1 , M. Konoglou1 , C. Nakou1 , M. Bitzani1 , I. Pnevmatikos2 . 1 1st ICU, G Papanikolaou Hospital, Thessaloniki, 2 ICU, Democritus University of Thrace, Alexandrupolis, Greece Rationale: Malnutrition has been found to be a predictor of poor outcome in patients with Cerebral Vascular accidents and Stroke. Aim of the study was to evaluate the adequacy of prescribed nutrition support (PNS) in comparison to measured by Indirect Calorimetry and estimated by Harris Bennedict caloric needs in Spontaneous intracranial hemorrhage (SICH) patients. Methods: Observational, prospective, cohort study comparing (PNS) to measured and predicted REE in critically ill SICH patients. Harris Benedict equation was used to evaluate predicted REE. REE was measured using Indirect Calorimetry (IC) on days 2, 3, 4, 7 and 10 post bleeding. Energy and Nitrogen balance were assessed at the same study points. There was no intervention on prescribed nutritional support (PNS). Results: 30 non septic SICH patients were included in the study. Mean predicted REE, mean measured REE and mean PNS were: 1580.3±262 Kcal/d, 1878.9±478 Kcal/d and 1212±466 Kcal/d respectively. There was a statistically significant difference (p < 0.005) between measured and predicted values, as well as between measured REE and PNS. Difference between predicted values and PNS was also significant, with the exception of days 7 and 10 (p = 0.59, p = 0.92). Although PNS increased significaly (p < 0.005) over time, post hoc analysis revealed that after the 4th day no difference was detected in the amount of PNS (1556±269 Kcal/d, p > 0.005). Energy balance remained negative over time. Nitrogen balance remained also negative with no significant variation throughout the study days. Proalbumin serum levels decreased significantly (p < 0.005) indicating underfeeding. Conclusion: Nutritional requirements of SICH patients are usually underestimated putting the patients at risk of underfeeding. Tailored nutritional support based on REE measured through Indirect Calorimetry is mandatory in order to meet energy requirements in this hypermetabolic group of patients. Disclosure of Interest: None Declared.
PP161-SUN THE BIOIMPEDANCE VECTOR ANALYSIS (BIVA) FOR THE ASSESSMENT OF MUSCLE MASS AND FUNCTION IN PATIENTS ON HOME PARENTERAL NUTRITION (HPN) FOR CHRONIC INTESTINAL FAILURE M. Guidetti1 , C. Pazzeschi1 , F. Agostini1 , R. Petitto1 , L. Pironi1 . 1 Center for Chronic Intestinal Failure, University of Bologna, Bologna, Italy Rationale: BIVA method for assessment of body composition is based on the impedance components, resistance and reactance, standardized for subject height and plotted as bivariate vector on a cartesian plane (the R-Xc graph-method). We evaluated the accuracy of BIVA for the assessment of muscle mass and function in HPN patients. Methods: A cross sectional study was performed in 53 adult patients, on HPN 6 months, PN infusions/week 3 week, for benign disease (25M/28F, age: 48±17/48±13 yrs). Impedance measurement: alternating current of 800 mA, 50 kHz. The skeletal Muscle Mass Index (SMI; kg/h2 ) was used to categorize the patients as normal or low muscle mass on the basis of measurements of appendicular skeletal lean mass by dualenergy x-ray absorptiometry (DEXA). Muscle function was assessed by hand grip strength (HGS; kg). Muscle Mass and Function: based on SMI and HGS values, subjects were categorized as: Normal (N; normal SMI and HGS), pre-sarcopenic (PS; ↓SMI, normal HGS), sarcopenic (S: ↓SMI and HGS). Statistics: Hotelling T2 tests. Results: Mean BIVA vector of patients with SMI lower than normal was sloped down than vector of those with normal SMI (M, p = 0.038; F, p = 0.021). In both genders, the mean vector becomes progressively longer and sloping down moving from N to PS and from PS to S (Males, N vs S: p = 0.007, PS vs S: p = 0.026; Females, N vs S: p = 0.008), and the mean vector of N and PS was placed in the area of normality of the R-Xc graph, whereas that of S was in the region of leanness.
Poster presentations Conclusion: The results support the accuracy of BIVA for the assessment of both mass and muscle function in patients on long-term HPN. Disclosure of Interest: None Declared.
PP162-SUN EVALUATION OF NUTRITION SUPPORT IN ICU PATIENTS WITH SPONTANEOUS INTRACRANIAL HEMORRHAGE P. Koukiasa1 , M. Konoglou1 , C. Nakou1 , M. Bitzani1 , I. Pnevmatikos2 . 1 1st ICU, G Papanikolaou Hospital, Thessaloniki, 2 ICU, Democritus University of Thrace, Alexandrupolis, Greece Rationale: Malnutrition has been found to be a predictor of poor outcome in patients with Cerebral Vascular accidents and Stroke. Aim of the study was to evaluate the adequacy of prescribed nutrition support (PNS) in comparison to measured by Indirect Calorimetry and estimated by Harris Bennedict caloric needs in Spontaneous intracranial hemorrhage (SICH) patients. Methods: Observational, prospective, cohort study comparing (PNS) to measured and predicted REE in critically ill SICH patients. Harris Benedict equation was used to evaluate predicted REE. REE was measured using Indirect Calorimetry (IC) on days 2, 3, 4, 7 and 10 post bleeding. Energy and Nitrogen balance were assessed at the same study points. There was no intervention on prescribed nutritional support (PNS). Results: 30 non septic SICH patients were included in the study. Mean predicted REE, mean measured REE and mean PNS were: 1580.3±262 Kcal/d, 1878.9±478 Kcal/d and 1212±466 Kcal/d respectively. There was a statistically significant difference (p < 0.005) between measured and predicted values, as well as between measured REE and PNS. Difference between predicted values and PNS was also significant, with the exception of days 7 and 10 (p = 0.59, p = 0.92). Although PNS increased significaly (p < 0.005) over time, post hoc analysis revealed that after the 4th day no difference was detected in the amount of PNS (1556±269 Kcal/d, p > 0.005). Energy balance remained negative over time. Nitrogen balance remained also negative with no significant variation throughout the study days. Proalbumin serum levels decreased significantly (p < 0.005) indicating underfeeding. Conclusion: Nutritional requirements of SICH patients are usually underestimated putting the patients at risk of underfeeding. Tailored nutritional support based on REE measured through Indirect Calorimetry is mandatory in order to meet energy requirements in this hypermetabolic group of patients. Disclosure of Interest: None Declared.