Comparison of bioimpedance and radioisotope methods in the estimation of extracellular water volume before and after coronary artery bypass grafting operation.

Abstract

To estimate extracellular water volume (ECW) changes in connection with coronary artery bypass grafting operation, simultaneous ECW estimations by 51Cr-EDTA dilution and whole-body bioimpedance techniques were performed in 15 patients. The assessments of ECW were compared with patients' weighing results. Whole-body bioimpedance-derived ECW correlated significantly with 51Cr-EDTA dilution-based ECW in the pre-operative period (r=0.74; P<0.005); the bias was 0.2 +/- 1.1 l (+/-SD). In the post-operative period, the agreement between these methods was poor, the bias being 0.5 +/- 2.5 l, and no significant correlation between the methods was found (r=0.38; P>0.05). Whole-body bioimpedance-derived ECW changes correlated significantly with weight changes of the patient induced by the operation (r=0.52; P<0.05). 51Cr-EDTA dilution-based ECW changes correlated neither with weight changes (r=0.33; P>0.05) nor with bioimpedance-derived ECW changes (r=0.03; P>0.05). Alterations in radioisotope tracer distribution and loss of it due to blood leakage in the post-operative period were presumed to explain the discrepancy between dilution technique and weighing results. The results suggest that bioimpedance is a useful non-invasive method for assessment of extracellular volume changes induced by coronary artery bypass grafting operations. 51Cr-EDTA dilution-based ECW determination is not suitable in related conditions.