Bioelectrical phase angle and impedance vector analysis - Clinical relevance and applicability of impedance parameters

Background & aims: The use of phase angle (PM) and raw parameters of bioelectrical impedance analysis (BIA) has gained attention as alternative to conventional error-prone calculation of body composition in disease. This review investigates the clinical relevance and applicability of PM and Bioelectrical Impedance Vector Analysis (BIVA) which uses the plot of resistance and reactance normalized per height. Methods: A comprehensive literature search was conducted using Medline identifying studies relevant to this review until March 2011. We included studies on the use of PM or BIVA derived from tetrapolar BIA in out- and in-patient settings or institutionalized elderly. Results: Numerous studies have proven the prognostic impact of PM regarding mortality or postoperative complications in different clinical settings. BIVA has been shown to provide information about hydration and body cell mass and therefore allows assessment of patients in whom calculation of body composition fails due to altered hydration. Reference values exist for PM and BIVA facilitating interpretation of data. Conclusion: PhA, a superior prognostic marker, should be considered as a screening tool for the identification of risk patients with impaired nutritional and functional status, BIVA is recommended for further nutritional assessment and monitoring, in particular when calculation of body composition is not feasible. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.