Body Composition Analysis of the Clinical Routine Using Air Displacement Plethysmography: Age-Group-Specific
Lennart A Lücke1,2, Niels Rochow3,4,5, Katja Knab3
1Department of Anaesthesiology and Intensive Care Medicine, Campus Charité Mitte und Charité Campus Virchow-Klinikum, Charité-Universitätsmedizin, 13353 Berlin, Germany.
Insights
Weekly routine body composition assessments using air displacement plethysmography (ADP) are feasible in preterm infants. Extremely preterm infants start ADP testing later, but the procedure is safe and provides valuable growth data.
Area of Science:
- Neonatal medicine
- Pediatric nutrition
- Body composition analysis
Background:
- Air displacement plethysmography (ADP) is increasingly used for neonatal body composition assessment.
- A standardized workflow is needed for routine ADP testing in term and preterm infants.
- Feasibility of weekly routine ADP testing in clinical practice requires evaluation.
Purpose of the Study:
- To analyze the feasibility of weekly routine air displacement plethysmography (ADP) testing in preterm infants.
- To determine the optimal timing and frequency of ADP assessments for different preterm groups.
- To assess the workload and clinical integration of ADP body composition measurements.
Main Methods:
- Retrospective analysis of clinical operating procedures at Nuremberg Children's Hospital.
- Evaluation of postnatal ages at first ADP assessment.
- Analysis of the number of weekly in-hospital assessments and workload per test cycle.
Main Results:
- Weekly routine ADP testing was proven feasible in clinical practice.
- Extremely preterm infants had a later mean postmenstrual age at first ADP test (36.6 weeks) compared to very preterm (34.2 weeks) and moderate to late preterm (35.3 weeks) infants.
- The mean number of tests before discharge was highest in extremely preterm infants (3.0).
- The workload was reasonable (8-13 minutes per test cycle).
Conclusions:
- Weekly routine ADP assessments are feasible and safe for preterm infants.
- ADP provides valuable data on infant nutritional status and growth.
- Standardized protocols and interpretation tools are needed to improve comparability and usability across institutions.
Abstract:
Body composition assessments using air displacement plethysmography (ADP, PEAPOD®) have been introduced into clinical practice at a few neonatal units. To allow accurate body composition assessments in term and preterm infants, a workflow for routine testing is needed. The aim of this study was to analyze the feasibility of weekly routine ADP testing. We analyzed (1) postnatal ages at first ADP assessment, (2) the number of weekly routine in-hospital assessments, and (3) the workload of body composition measurements using ADP in clinical practice on the basis of an retrospective analysis of our own clinical operating procedures. The retrospective analysis of weekly routine ADP testing proved feasible at Nuremberg Children's Hospital. The analysis of postnatal age at the first ADP test revealed differences across groups, with extremely preterm infants starting at a mean postmenstrual age of 36.6 weeks, very preterm infants starting at 34.2 weeks, and moderate to late preterm infants starting at 35.3 weeks. The mean number of tests before discharge was significantly greater in the extremely preterm group (n = 3.0) than in the very preterm (n = 2.4) and moderate to late preterm groups (n = 1.7). The workload of the procedure is reasonable, at 8-13 min per test cycle. The study proved that weekly routine ADP assessments in preterm infants are feasible. However, the initiation of routine testing in extremely preterm infants starts at a significantly greater postnatal age than in the more mature population. ADP assessments can be safely and easily integrated into clinical practice and may be valuable tools for providing additional information on nutritional status and infant growth. A standardized routine protocol allowing identical measurement conditions across healthcare institutions and a standardized interpretation tool for age-adapted body composition data, however, would improve comparability and usability.
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