The assessment of hydration states in advanced cancer patients using novel technology: the evaluation of bioelectrical impedance vector analysis (BIVA) in the palliative care setting

Nwosu, Amarachukwu ORCID: 0000-0003-0014-3741 The assessment of hydration states in advanced cancer patients using novel technology: the evaluation of bioelectrical impedance vector analysis (BIVA) in the palliative care setting. PhD thesis, University of Liverpool.

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Abstract

The role of hydration in causing or alleviating suffering in patients with advanced cancer is poorly understood and remains controversial. Most dying cancer patients have reduced oral intake in the last days of life. This may be related to symptoms arising from the cancer or its treatment, such as dysphagia, anorexia, nausea, vomiting, or mechanical problems such as bowel obstruction. Accordingly, the subject of clinically assisted hydration (CAH) is emotive amongst patients and their carers, with the omission or withdrawal of CAH potentially viewed as hastening death in some instances. Current hydration assessment methods are limited in cancer patients approaching death. Bioelectrical impedance vector analysis (BIVA) is an accurate validated method of assessing body composition; however its clinical use in advanced cancer is uncertain. This study aims to measure hydration in advanced cancer patients using BIVA, in order, to determine the relationship between symptoms, physical signs and biochemistry. BIVA was used to evaluate hydration in advanced cancer patients within a hospice in the UK. Total body water (TBW) was estimated using the impedance index (Height2/Resistance [H2/R]). Regression analysis determined the predictive properties of clinical variables on H2/R. Assessed items included: performance status (ECOG), symptoms (Burge-4 score), physical signs (Morita Dehydration Score) and biochemistry. Ninety patients participated (recruitment rate = 76.3%). Hydration status was normal in 43 (47.8%), ‘more hydrated’ in 37 (41.1%) and ‘less hydrated’ in 10 (11.1%) patients. A multiple regression analysis was conducted. H2/R was significantly predicted by female gender (Beta = -13.85, p

Item Type:	Thesis (PhD)
Additional Information:	alt_title: Hydration in advanced cancer Date: 2015-03 (completed)
Uncontrolled Keywords:	Palliative medicine, palliative care, end of life, hydration, science, fluid, homeostasis, dehydration, supportive care, cancer, oncology, physiology, hospice, bioelectrical impedance analysis, bioelectrical impedance vector analysis, BIA, BIVA
Subjects:	?? QP ?? ?? R1 ?? ?? RC ?? ?? RC0254 ??
Depositing User:	Symplectic Admin
Date Deposited:	28 Jan 2016 08:55
Last Modified:	17 Dec 2022 01:43
DOI:	10.17638/02008486
URI:	https://livrepository.liverpool.ac.uk/id/eprint/2008486