Objective Although fluid resuscitation is the cornerstone of treatment for sepsis, the role of body water status in sepsis is poorly understood. This study aimed to understand how body water and its distribution are modified in patients with sepsis and those with non-septic infection compared to healthy individuals.
Methods Two groups of adults presumed to have non-septic infection (n=87) and sepsis (n=54) were enrolled in this prospective study in a single emergency department, and they were compared to sex-, age-, and height-matched (1:3 ratio) healthy controls (n=11,190) from retrospective data in a health promotion center. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW), determined using direct segmental multi-frequent bioelectrical impedance analysis (InBody S10) were expressed as indices for normalization by body weight (BW). The ratio of ECW to TBW (ECW/TBW) was evaluated to determine body water distribution.
Results TBW/BW, ICW/BW, and ECW/BW were significantly higher in the non-septic infection group than in the healthy group (P<0.001), but ECW/TBW was not significantly different (P=0.690). There were no differences in TBW/BW and ICW/BW between the sepsis and healthy groups (P=0.083 and P=0.963). However, ECW/BW and ECW/TBW were significantly higher in the sepsis group than in the healthy group (P<0.001).
Conclusion Compared to the healthy group, the ratio of body water to BW was significantly increased in the non-septic infection group, while ECW/BW and ECW/TBW were significantly increased in the sepsis group. These indices could be utilized as diagnostic variables of body water deficit in septic patients.
Citations
Citations to this article as recorded by
Bioimpedance measurements of fibrotic and acutely injured lung tissues Mohammad Mir, Jiawen Chen, Aneri Patel, Meghan R. Pinezich, Maria R. Hudock, Alexander Yoon, Mohamed Diane, John O'Neill, Matthew Bacchetta, Gordana Vunjak-Novakovic, Jinho Kim Acta Biomaterialia.2025; 194: 270. CrossRef
Community‐Based Pilot Study of a Wrist‐Worn Bioimpedance Hydration Sensor and Its Implications for Understanding the Relationship Between Hydration and Cognitive Function Isaac Opoku, Eamon Johnson, Shravan Khare, Adam T. Perzynski, Mary Joan Roach Health Science Reports.2025;[Epub] CrossRef
Bioelectrical impedance analysis to assess body water status during fluid infusion in a rat model of extracorporeal membrane oxygenation Soojin Lee, Seunghwan Song, Jong Hwan Park, Jun-Hyok Oh, Harin Rhee, Minji Sung, In-Seok Jeong, Mukhammad Kayumov, Hye Won Yun, Yang Hyun Cho Scientific Reports.2025;[Epub] CrossRef
Effect of rigorous fluid management using monitoring of ECW ratio by bioelectrical impedance analysis in critically ill postoperative patients: A prospective, single-blind, randomized controlled study Yoon Ji Chung, Gyeo Ra Lee, Hye Sung Kim, Eun Young Kim Clinical Nutrition.2024; 43(9): 2164. CrossRef
Handgrip strength is correlated with activities of daily living, balance, and body composition in patients with thoracolumbar compression fracture Hirokazu Inoue, Yukinori Hayashi, Hideaki Watanabe, Hideaki Sawamura, Yasuyuki Shiraishi, Ryo Sugawara, Atsushi Kimura, Masaaki Masubuchi, Katsushi Takeshita Medicine.2023; 102(9): e33141. CrossRef
Sepsis-like Energy Deficit Is Not Sufficient to Induce Early Muscle Fiber Atrophy and Mitochondrial Dysfunction in a Murine Sepsis Model Alexandre Pierre, Claire Bourel, Raphael Favory, Benoit Brassart, Frederic Wallet, Frederic N. Daussin, Sylvain Normandin, Michael Howsam, Raphael Romien, Jeremy Lemaire, Gaelle Grolaux, Arthur Durand, Marie Frimat, Bruno Bastide, Philippe Amouyel, Eric B Biology.2023; 12(4): 529. CrossRef
Feasibility study using longitudinal bioelectrical impedance analysis to evaluate body water status during fluid resuscitation in a swine sepsis model Hwain Jeong, Inwon Park, Jae Hyuk Lee, Dongsung Kim, Sumin Baek, Seonghye Kim, You Hwan Jo Intensive Care Medicine Experimental.2022;[Epub] CrossRef
Atazanavir is a protease inhibitor approved for use in combination with other antiretroviral drugs for the treatment of human immunodeficiency virus infection. Atazanavir and other protease inhibitors can sometimes induce corrected QT prolongation and ventricular arrhythmia. A 40-year-old man with no comorbidities, except human immunodeficiency virus 1 infection, presented with palpitations 3 days after an overdose of 150 caps of atazanavir, with suicidal intent. His initial electrocardiogram showed monomorphic ventricular tachycardia, and hyperbilirubinemia was observed in his initial blood test. Immediately after magnesium sulfate infusion, his ventricular tachycardia was converted into junctional bradycardia with prolonged corrected QT. After 3 days of close observation in the intensive care unit, the corrected QT prolongation and hyperbilirubinemia were normalized.