Therapeutic effects of pleural and abdominal fluid filtration, concentration, and reinjection based on bioelectrical...

The use of bioelectrical impedance analysis (BIA) has enabled measurement of the amounts of body components. Terminal cancer patients often experience excessive fluid retention. In this study, we investigated the effect of cell-free and concentrated ascites reinfusion therapy (CART) on fluid retention in terminal cancer patients using BIA.

Of the 676 patients, 176 underwent CART, with 6 patients having measured total body water (TBW), extracellular water (ECW) and body fluid balance (ECW/TBW) using BIA before and after CART.

Body composition measurements were obtained a total of 45 times before and after CART. The median (quartile) drained fluid volume by CART was 3000 mL (800-6000). After CART, the ECW/TBW improved to 0.413 (0.408-0.420) in patients with ascites. Correlation with pre-CART anthropometric analysis showed a positive correlation between water loss and TBW and ECW/TBW (R=0.415 and 0.528, P<0.001 and 0.001, respectively). A strong correlation was also observed between body weight and TBW and BCM (R=0.892 and 0.897, P<0.001 and 0.001, respectively). Furthermore, in cases with a large amount of fluid removal, BCM decreased by approximately 9 kg, from 32.3 kg to 23.2 kg. ECW/TBW, a measure of edema, was 0.465 before the start of the study, indicating severe fluid retention, but eventually improved to 0.404.

In terminal cancer patients having refractory fluid retention, CART ameliorated edema. It was suggested that fluid retention may affect measurements of somatic cell volume, potentially hindering accurate assessment of these values.