Phase angle as a prognostic indicator in critically ill children: A systematic review

Area of Science:

• Biomedical Engineering
• Pediatric Critical Care Medicine
• Nutritional Physiology

Background:

• Phase angle (PhA) is a bioelectrical impedance analysis (BIA) parameter reflecting cellular health.
• Previous research indicates PhA's utility in assessing disease severity in critically ill adults.
• Limited data exists on PhA's association with clinical outcomes in critically ill children.

Purpose of the Study:

• To systematically review the association between PhA at pediatric intensive care unit (PICU) admission and clinical outcomes in critically ill children.
• To synthesize current evidence on PhA as a prognostic marker in pediatric critical care.

Main Methods:

• Systematic literature search of PubMed/Medline, Scopus, Web of Science, EMBASE, and LILACS up to July 22, 2022.
• Inclusion of prospective studies evaluating PhA at PICU admission and clinical outcomes.
• Data extraction on study characteristics, BIA protocols, PhA classification, and outcomes; risk of bias assessed using the Newcastle-Ottawa Scale.

Main Results:

• Five prospective studies were included from 4669 screened articles.
• Lower PhA values at PICU admission were associated with longer PICU and hospital stays.
• Lower PhA correlated with increased duration of mechanical ventilation, higher risk of septic shock, and increased mortality.

Conclusions:

• Phase angle shows potential as a prognostic indicator for clinical outcomes in critically ill children.
• Limitations include small sample sizes, diverse clinical conditions, and methodological variations in BIA protocols and PhA cutoffs.
• Further large-scale studies with standardized PhA assessment are needed to confirm its predictive value.