Utilization of Bio Impedance Spectroscopy in lieu of Invasive Monitoring for Monitoring Fluid Overload

Abstract

Andrew J Accardi and J Thomas Heywood

Congestive heart failure (CHF) has become one of the most common diagnoses and a leading cost concern for Medicare and insurance companies. The majority of costs associated with CHF surround hospitalization and re-admissions. As a result of these rising costs, there has been a push to identify early markers of impending congestion as a surveillance tool and possible measure of effectiveness of treatment. The measurement of diastolic pulmonary artery (PA) pressure from invasive devices has been shown to be useful in the management of New York Heart Association (NYHA) class III heart failure (HF) patients. It has been suggested that bio impedance spectroscopy (BIS) could be used as a surrogate for volume overload, offering a non-invasive option for patients. We present a case of a NYHA class III HF patient with end stage liver disease. The patient had previously been implanted with a Cardio MEMS device. Over several weeks, diastolic PA pressures and weight were compared to BIS measures from a SOZO, (noninvasive fluid monitoring system). The use of BIS to estimate extracellular fluid accumulation shows excellent correlation to both diastolic PA pressure and weight, suggesting a use for non-invasive monitoring.

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