Assessment of Fluid Overload in Critically Ill Patients: Role of Bioelectrical Impedance Analysis

  • M. L. N. G. MalbrainEmail author
  • E. De Waele
  • P. M. Honoré
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


The association of a positive fluid balance and increased morbidity and mortality has been well documented [1, 2, 3, 4, 5]. However, little is known about the best method to assess fluid status and fluid overload. Fluid overload is defined by a cut-off value of 10% fluid accumulation above baseline body weight [5, 6, 7]. The human body consists of around 60% of water, 18% protein, 16% fat and 6% minerals [8]. Intracellular water (ICW) counts for two‐thirds of total body water (TBW) while one‐third is extracellular water (ECW). ECW contains 75% interstitial fluid and 25% intravascular fluid. Thus, the plasma accounts for only 5.5% of TBW. In critically ill patients, fluid overload results mainly from excessive fluid administration. After 1 h, infusion of 1 l of isotonic fluid (e.g., so‐called normal saline) will increase the intravascular volume by 250 ml and the interstitial fluid volume by 750 ml. On the other hand, infusion of 1 l of hypotonic fluid...


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • M. L. N. G. Malbrain
    • 1
    • 2
    Email author
  • E. De Waele
    • 1
  • P. M. Honoré
    • 1
  1. 1.Dept of Intensive CareUniversity Hospital BrusselsBrusselsBelgium
  2. 2.Intensive Care Unit and High Care Burn UnitZiekenhuis Netwerk Antwerpen, ZNA StuivenbergAntwerpBelgium

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