Nutrición Hospitalaria 00770 / http://dx.doi.org/10.20960/nh.770
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Trabajo Original

Phase angle and onodera’s prognostic nutritional index in critically ill patients


Karina Marques Vermeulen, Leilane Lilian Araújo Leal, Mariana Camara Martins Bezerra Furtado, Sancha Helena De Lima Vale, Lúcia Leite Lais

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Introduction: Assessing severity and nutritional prognosis in critical patients has become increasingly important in recent years, since these parameters are related to morbidity/mortality and used to guide therapeutic options. Objective: Determine nutritional prognosis through the Phase Angle (PA) and Onodera’s Prognostic Nutritional Index (OPNI) and its relationship with severity, hospitalization time and mortality of critically ill patients. Methods: Descriptive cross-sectional study, involving adult patients hospitalized in an Intensive Care Unit (ICU). Data were collected from the patients’ medical records to calculate severity indicators (APACHE II, SOFA and SAPS 3) and determine the length of hospitalization and outcome. Bioimpedance was conducted to calculate the PA, using resistance and reactance data. Results: A total of 35 patients (26% men and 74% women), with mean age of 55.5 ± 16.7 years, were included. The mortality rate (17%) was similar to that expected by APACHE II and SOFA, but higher than that predicted by SAPS 3. The mean values for the PA (4.2 ± 1.0) and OPNI (38.7 ± 8.3) were lower than the reference values adopted. Individuals with PA < 5.1 exhibited significantly lower reactance and albumin and higher APACHE II and SOFA values, in addition to longer hospitalization time and higher mortality. The PA was inversely correlated with all the severity indicators under study (APACHE II, SOFA and SAPS 3), and the length of hospitalization. By contrast, there was no correlation between OPNI and these parameters, or between PA and OPNI.Conclusion: The PA proved to be a good tool in assessing nutritional prognosis in critically ill patients. By contrast, more studies using the OPNI with this type of patients are needed.

Palabras Clave: Intensive care. Critical illness. Nutrition. Prognosis



Vermeulen, Karina M., Lopes, Márcia M. G. D., Grilo, Evellyn C., Alves, Camila X., Machado, Richele J. A., Lais, Lucia L., Brandão-Neto, José, Vale, Sancha H. L. (2019) Bioelectrical impedance vector analysis and phase angle in boys with Duchenne muscular dystrophy. Food & Nutrition Research
Gonzalez‐Granda, Anita, Schollenberger, Asja, Haap, Michael, Riessen, Reimer, Bischoff, Stephan C. (2019) Optimization of Nutrition Therapy with the Use of Calorimetry to Determine and Control Energy Needs in Mechanically Ventilated Critically Ill Patients: The ONCA Study, a Randomized, Prospective Pilot Study. Journal of Parenteral and Enteral Nutrition
Pena, Natália F., Mauricio, Sílvia F., Rodrigues, Ana M.S., Carmo, Ariene S., Coury, Nayara C., Correia, Maria I.T.D., Generoso, Simone V. (2019) Association Between Standardized Phase Angle, Nutrition Status, and Clinical Outcomes in Surgical Cancer Patients. Nutrition in Clinical Practice
Vermeulen, Karina M., Lopes, Márcia Marília G. D., Alves, Camila X., Brito, Naira J. N., Almeida, Maria das Graças, Leite-Lais, Lucia, Vale, Sancha Helena L., Brandão-Neto, José (2019) Bioelectrical Impedance Vector Analysis and Phase Angle on Different Oral Zinc Supplementation in Eutrophic Children: Randomized Triple-Blind Study. Nutrients
Zheng, Wen-He, Zhao, Yi-He, Yao, Yan, Huang, Hui-Bin (2023) Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis. Frontiers in Medicine
Vermeulen-Serpa, Karina Marques, Lopes, Márcia Marília Gomes Dantas, Miranda, Carolinne Thaisa de Oliveira Fernandes, Alves, Camila Xavier, Leite-Lais, Lucia, Brandão-Neto, José, Vale, Sancha Helena de Lima (2023) Gender-specific bioelectrical impedance reference values in healthy children. Clinical Nutrition Open Science
Lima, Júlia, Eckert, Igor, Gonzalez, Maria Cristina, Silva, Flávia Moraes (2022) Prognostic value of phase angle and bioelectrical impedance vector in critically ill patients: A systematic review and meta-analysis of observational studies. Clinical Nutrition
Stapel, Sandra N., Looijaard, Wilhelmus G. P. M., Dekker, Ingeborg M., Girbes, Armand R. J., Weijs, Peter J. M., Oudemans-van Straaten, Heleen M (2018) Bioelectrical impedance analysis-derived phase angle at admission as a predictor of 90-day mortality in intensive care patients. European Journal of Clinical Nutrition
Madsen, Janne M., Wichmann, Sine, Bestle, Morten H., Itenov, Theis S. (2021) Bioimpedance as a measure of fluid status in critically ill patients: A systematic review. Acta Anaesthesiologica Scandinavica
Azevedo, Zina Maria Almeida de, Santos Junior, Bráulio dos, Ramos, Eloane Gonçalves, Salú, Margarida dos Santos, Mancino da Luz Caixeta, Daniella, Lima-Setta, Fernanda, Jacques, Melissa Lorena, Mattos da Fonseca, Vania, Pedroso, Elza Rosa, Moore, Daniella Campelo Batalha Cox (2020) The importance of bioelectrical impedance in the critical pediatric patient. Clinical Nutrition
Ferreira, Rannapaula Lawrynhuk Urbano, da Silva, Miriam Farias, de Macedo Olimpio, Nathalya Julianny, Oliveira, Márcia Regina Dantas de Araújo, Vermeulen-Serpa, Karina Marques, Brandão-Neto, José, Lima Vale, Sancha Helena, Leite-Lais, Lucia, Lopes, Marcia Marilia Gomes Dantas (2023) The positive relationship between NUTRIC score, bioelectric measures and hospital mortality in critically ill patients. Nutrition & Food Science

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