• Written by  Henry C. Lukaski

A review of the development of BIA methodology and clinical applications

Evolution of bioimpedance: a circuitous journey from estimation of physiological function to assessment of body composition and a return to clinical research”
H C Lukaski
Eur J Clin Nutr. 2013 Jan; 67 Suppl 1: S2-9. doi: 10.1038/ejcn.2012.149

In this 2013 review, Henry C. Lukaski, one of the most cited authors in the field of bioelectrical impedance analysis (BIA), explores the range of current clinical applications of BIA, starting with a discussion of bioimpedance models and algorithms. Ample attention is given to analyses of body composition, hydration status, regional fluid accumulation, wound healing, and prognosis. Both the strengths and limitations of each application are discussed, with comments on factors that may limit the accuracy of the results. He notes that “use of the single- and multiple-frequency bioimpedance analysis using the simple conductor-volume model and multiple regression analysis resulted in large errors of prediction” of total body water, extracellular body water, and fat-free mass, and that “reliance on the constancy of the composition of the fat-free body (for example, hydration), consistent body geometry and the use of constant values for intracellular and extracellular resistivity contributed to the errors in the estimation of body composition.”

In contrast, when discussing BIVA, he finds that “the combination of raw bioimpedance values and avoidance of mathematical prediction equations appears to have overcome these limitations. The use of BIVA to classify and rank hydration in various clinical conditions, the application of the ratio of low to high impedance in regional assessments of lymphoedema, longitudinal measurements of single-frequency bioimpedance to monitor wound healing, determinations of phase angle to aid in prognosis and regional bioimpedance measurements to evaluate skeletal muscle in neuromuscular disease are novel and promising applications.”



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