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[Association between phase angle, PRISM I and sepsis severity]
Zina Maria Almeida de Azevedo1, Dilma Ribeiro Silva, Maria Virgínia P Dutra2
1Instituto Fernandes Figueira, FIOCRUZ.
Insights
Low phase angle in pediatric critical patients may indicate a poorer prognosis. This study found that the lowest phase angle values correlated with higher Pediatric Risk of Mortality I scores in critically ill children.
Area of Science:
- Biophysics
- Critical Care Medicine
- Nutritional Assessment
Context:
- Phase angle (PA), derived from bioelectrical impedance analysis (BIA), reflects body cell mass and cellular integrity.
- Low phase angle is linked to increased morbidity and mortality in critically ill patients.
- Understanding PA's role in pediatric critical care is crucial for prognosis.
Purpose:
- To investigate the relationship between phase angle and the Pediatric Risk of Mortality I (PRISM I) score.
- To explore the association between phase angle and sepsis severity in pediatric patients.
- To determine the prognostic implications of phase angle in the Pediatric Intensive Care Unit (PICU).
Summary:
- A transversal study in a PICU evaluated 75 pediatric patients, including 68 with sepsis.
- Phase angle measurements using BIA were analyzed in relation to PRISM I scores, sepsis severity, and multiple organ dysfunction syndromes (MODS).
- While no significant differences were found across PRISM I or MODS categories, the lowest phase angle values (1.5º-2.2º) were associated with the highest PRISM I scores (>30%).
Impact:
- Low phase angle values in pediatric critical patients may serve as a prognostic indicator.
- This finding highlights the potential utility of phase angle in assessing the severity and predicting outcomes for critically ill children, particularly those with sepsis.
- Further research can explore therapeutic interventions to improve phase angle and patient outcomes.
Background And Objectives:
Phase angle (PA) is the difference between voltage and current and can be used as an indicator of body cell mass. Clinical studies show that low phase angle is associated with morbidity and mortality of critical patients. The purpose of this study was to know the relation between phase angle and the Pediatric Risk of Mortality I (PRISM I) score, associating this score with the severity of sepsis.
Methods:
A transversal study was performed at the Pediatric Intensive Care Unit (PICU) in Instituto Fernandes Figueira. The patients were classified according to age, gender, sepsis severity, cause of respiratory failure, PRISM I score, multiple organ dysfunction syndromes (MODS). Electrical bioimpedance analysis (BIA) was performed in all patients. Phase angle was calculated directly from reactance (Xc) and resistance (R). AF = arc-tangent reactance/resistance x 180º/Pi.
Results:
75 patients (68 septic) were evaluated. The incidence of septic shock was 39.7%, severe sepsis 42.6% and sepsis 17.6%. There was no significative statistical difference between the mean values of BIA and the categories of PRISM I, MODS, or the length of stay the PICU. The PA's lowest values (1.5º-2.2º) were associated to the greatest PRISM's scores (> 30%).
Conclusions:
Pediatric critical patients show low phase angle values, which might have prognostic implication.
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