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Ursula G Kyle

Publications and source records attributed to Ursula G Kyle.

29 records · Page 2Linked to original sources
PubMed2004

[Role of impedance measurement in nutritional screening].

Nutritional status has a prognostic value in the clinical evolution of patients who are malnourished, are becoming malnourished or are in process of being rehabilitated. The evaluation of nutritional status is based on a comprehensive approach, and includes body composition measurement by bio-impedance analysis (BIA). BIA determines the quantity of body fat-free and fat mass and has a precision around 4%. The reliability of BIA depends on the use of body composition prediction equations that are adapted to the subjects studied and on the inclusion of various anthropometric parameters (weight, height, sex, age, race, etc). BIA remains imprecise in the presence of abnormal distribution of body compartments (ascites, dialysis, lipodystrophy) or of extreme weights (cachexia, severe obesity). Multi-frequency or segmental BIA were developed to overcome hydration abnormalities and variations in body geometry. However, these techniques require further validation. This review discusses the indications and limitations of BIA.

Anthropometry↗
PubMed2003

Four-year follow-up of body compostion in lung transplant patients.

BACKGROUND: Both undernutrition and overnutrition can affect the quality of life and survival of patients with pulmonary disease and lead to quantitative and functional alterations of fat-free mass (FFM). This longitudinal study determines the changes in weight, FFM, and body fat before and up to 4 years after lung transplant (LTR). METHODS: Height, weight, and body composition measurements (bioelectrical impedance) were obtained in 37 LTR patients. FFM and body fat were measured before and at 1, 3, 6, 9, 12, 18, 24, 36, and 48 months after LTR. RESULTS: Weight changed by +16.6%, +3.2%, -0.2%, and -3.2% and FFM by +14.0%, +2.5%, -0.3%, and -1.0% during years 1, 2, 3, and 4, respectively. A diagnosis of obliterative bronchiolitis after LTR was associated with loss of body weight, FFM, and body fat, compared with stable weight or gain in weight, FFM, and body fat in obliterative bronchiolitis-negative subjects; 76.2% and 85.7%, and 28% and 38% of men and women, respectively, demonstrated low FFM at 1 month and at 2 years after LTR, respectively. The FFM change was higher (39% of weight) during year 1 than during year 2 (25%) or year 3 (21%). CONCLUSIONS: After LTR, patients gained weight, FFM, and body fat, and two-thirds reached normal levels of FFM by year 2. A weight increase resulted in an FFM increase. Contrary to studies after heart or liver transplantation, our results suggest that despite posttransplant infections and grafts rejection, LTR permits FFM recovery.

Adipose Tissue↗
PubMed2003

Body composition measurements: interpretation finally made easy for clinical use.

PURPOSE OF REVIEW: This review presents the latest clinical applications of bioelectrical impedance analysis. It discusses the evaluation of nutritional status by using fat-free mass and body fat, percentiles of fat-free mass and body fat, height-normalized fat-free mass and body fat mass indices and a resistance/reactance vector graph. RECENT FINDINGS: Fat-free mass and body fat can be used to evaluate nutritional status by comparing individuals or groups of individuals with themselves or with reference values. Percentile distributions are also useful in determining whether individuals or groups fall within the population range. Percentile ranks can also be used to define nutritional depletion and obesity. The use of the fat-free mass and body fat mass indices has the advantage of compensating for differences in body height. The use of low, normal, high and very high fat-free mass and body fat mass indices ranges that correspond to underweight, normal, overweight and obese body mass index categories further aid in the nutritional assessment process. With vector bioelectrical impedance analysis, an individual impedance vector is compared with the 50, 75, and 95% tolerance ellipses calculated in the reference, healthy population, allowing evaluation in any clinical condition. More accurate estimates of conventional bioelectrical impedance analysis equations might be obtained in individuals with a normal impedance vector. SUMMARY: The assessment of fat-free mass and body fat provides valuable information about changes in body composition with weight gain or loss and physical activity, and during ageing. The use of percentiles and height-normalized fat-free mass and body fat permit the classification of patients as under or overnourished.

Adipose Tissue↗
PubMed2002

Body composition in 995 acutely ill or chronically ill patients at hospital admission: a controlled population study.

OBJECTIVE: To determine if fat-free mass and fat mass in acutely ill and chronically ill patients differed from healthy controls at hospital admission and if prevalence of malnutrition differed by body mass index (BMI) or fat-free mass percentile. SUBJECTS/SETTING: 995 consecutive patients 15 to 100 years of age admitted to the hospital were measured in the hospital admission center and compared with 995 healthy age- and height-matched subjects DESIGN: Cross-sectional study. Fat-free mass, fat mass, and percentage fat mass were determined by 50 kHz bioelectrical impedance analysis. Prevalence of malnutrition was determined by BMI < or = 20 kg/m2 or fat-free mass in the 10th percentile. STATISTICAL ANALYSIS: Analysis of variance was used to examine differences between acutely ill and chronically ill patients and controls and between age groups. RESULTS: Fat-free mass was significantly lower in patients than controls (P< or = .05), and the difference with age in fat-free mass in patients was greater than the age-related difference in the controls. A higher percentage fat mass was found in spite of lower BMI in chronically ill patients older than 55 years. Among participants, 25% of acutely ill and 37.3% of chronically ill patients fell below fat-free mass in the 10th percentile, compared with 15.6% of acutely ill and 18.9% of chronically ill patients falling below BMI < or = 20 kg/m2. APPLICATIONS/CONCLUSION: Weight and BMI do not evaluate body compartments and therefore do not reveal if weight changes result in loss of fat-free mass or gain in fat mass. In spite of minimal differences in BMI between patients and controls, we found that fat-free mass was lower and fat mass was higher in acutely ill and chronically ill patients than controls. The objective measurement of body composition, as part of a comprehensive nutritional assessment, helps to identify subjects who have low fat-free mass or high fat mass.

Acute Disease↗
PubMed2002

Nutrition status in patients younger and older than 60 y at hospital admission: a controlled population study in 995 subjects.

OBJECTIVE: Body weight and body mass index are easily obtainable indicators of nutrition status but do not provide information on changes in fat-free mass (FFM) and fat mass with age. In this prospective controlled study, we investigated whether body composition measurements were useful in identifying moderately or severely depleted patients, as judged by the Subjective Global Assessment at hospital admission. In addition, the subjects were grouped by age (< or =60 and >60 y) to determine whether there was an effect of aging on the prevalence of malnutrition. METHODS: Nine hundred ninety-five consecutive patients were evaluated for malnutrition by body mass index, serum albumin, Subjective Global Assessment, and 50-kHz bioelectrical impedance analysis and compared with 995 age- and height-matched healthy volunteers for FFM and fat mass. RESULTS: A body mass index less than 20 kg/m(2) was found in 17.3% of patients. Low albumin (< or =34.9 g/L) was found in 14.9% of all patients and 23.7% of those older than 60 y. In contrast, 23.1% and 38.3% of all patients were severely and moderately depleted, respectively, according to the Subjective Global Assessment. FFM was significantly lower in severely depleted men and women and moderately depleted women (P < or = 0.001), and fat mass was significantly higher (P < or = 0.05) in well-nourished patients than in volunteers. Patients older than 60 y had lower FFM and higher fat mass than did patients 60 y or younger or volunteers (P < or = 0.001). CONCLUSION: The prevalence of malnutrition was greater in patients older than 60 y than in those 60 y and younger. Patients classified as severely depleted according to the Subjective Global Assessment were depleted of FFM. Body composition measurement can help to identify patients with low FFM and high fat mass.

Adipose Tissue↗
PubMed2002

Body composition: what's new?

PURPOSE OF REVIEW: Body mass index has been shown to be an imprecise measurement of fat-free and fat mass, and provides no information if weight changes occur as a result of a decrease in fat-free mass or an increase in fat mass. RECENT FINDINGS: Non-invasive body composition methods (i.e. bioelectrical impedance analysis, air displacement plethysmography) can now be used to monitor fat-free and fat mass with weight gain and loss, and during aging. This review discusses body composition measurements in terms of ethnic differences, physical activity, and age, and the limitations of bedside techniques in obesity and abnormal hydration status. SUMMARY: An assessment of the fat-free and fat mass provides valuable information about changes in body composition with weight gain or loss and physical activity, and during aging. Non-invasive bedside techniques can now be used to evaluate the nutritional status of healthy and ill individuals.

Adipose Tissue↗
PubMed2002

[ Evaluation of the nutritional state of patients in emergency services: contribution in measurement of body composition].

Weight and body mass index are used in clinical routine to detect malnourished patients. However, a study performed at the emergency admission of the University Hospital of Geneva shows that the prevalence of malnutrition is very underestimated when based on body mass index instead of fat-free mass. Indeed, a third of the patients with normal body mass index, i.e. between 20 and 24.9 kg/m2, present a fat-free mass under percentile 10. This suggests that the body mass index alone cannot be used as diagnostic criteria for malnutrition. This review describes the prevalence of malnutrition at the emergency admission of the University Hospital of Geneva, the prevalence of malnutrition in the literature and its relationship with length of hospital stay and mortality.

Anthropometry↗
PubMedDate not supplied

Body composition interpretation. Contributions of the fat-free mass index and the body fat mass index.

OBJECTIVE: Low and high body mass index (BMI) values have been shown to increase health risks and mortality and result in variations in fat-free mass (FFM) and body fat mass (BF). Currently, there are no published ranges for a fat-free mass index (FFMI; kg/m(2)), a body fat mass index (BFMI; kg/m(2)), and percentage of body fat (%BF). The purpose of this population study was to determine predicted FFMI and BFMI values in subjects with low, normal, overweight, and obese BMI. METHODS: FFM and BF were determined in 2986 healthy white men and 2649 white women, age 15 to 98 y, by a previously validated 50-kHz bioelectrical impedance analysis equation. FFMI, BFMI, and %BF were calculated. RESULTS: FFMI values were 16.7 to 19.8 kg/m(2) for men and 14.6 to 16.8 kg/m(2) for women within the normal BMI ranges. BFMI values were 1.8 to 5.2 kg/m(2) for men and 3.9 to 8.2 kg/m(2) for women within the normal BMI ranges. BFMI values were 8.3 and 11.8 kg/m(2) in men and women, respectively, for obese BMI (>30 kg/m(2)). Normal ranges for %BF were 13.4 to 21.7 and 24.6 to 33.2 for men and women, respectively. CONCLUSION: BMI alone cannot provide information about the respective contribution of FFM or fat mass to body weight. This study presents FFMI and BFMI values that correspond to low, normal, overweight, and obese BMIs. FFMI and BFMI provide information about body compartments, regardless of height.

Adipose Tissue↗
PubMedDate not supplied

Physical characteristics of total parenteral nutrition bags significantly affect the stability of vitamins C and B1: a controlled prospective study.

BACKGROUND: Vitamin degradation occurring during the storage of total parenteral nutrition (TPN) mixtures is significant and affects clinical outcome. This study aimed to assess the influence of the TPN bag material, the temperature, and the duration of storage on the stability of different vitamins. METHODS: Solutions of multivitamin and trace elements at recommended doses were injected into either an ethylvinyl acetate (EVA) bag or a multilayered (ML) bag filled with 2500 mL of an identical mixture of carbohydrates (1200 kcal), fat (950 kcal), and amino acids (380 kcal). The bags were then stored at 4 degrees C, 21 degrees C, or 40 degrees C. Concentrations of vitamins A, B1, C, and E were measured up to 72 hours after compounding, using high-pressure liquid chromatography. RESULTS: Ten percent to 30% of vitamin C degradation occurred within the first minutes after TPN compounding. Vitamin C was more stable in ML bags (half-life: 68.6 hours at 4 degrees C, 24.4 hours at 21 degrees C, and 6.8 hours at 40 degrees C) than in EVA bags (half-life: 7.2 hours at 4 degrees C, 3.2 hours at 21 degrees C, and 1.1 hour at 40 degrees C). Moreover, appearance of dehydroascorbic acid in the TPN mixture did not compensate for vitamin C losses. Vitamin B1 was stable at 21 degrees C, but a 43% loss occurred at 40 degrees C after 72-hour storage in EVA bags. The other vitamins were stable in the TPN mixture stored in both bags at any temperature and without daylight protection. CONCLUSIONS: Degradations of vitamins C and B, are significantly reduced in ML bags compared with EVA bags. To prevent vitamin C deficiencies, its initial dose should be adapted to its degradation rate, which depends on the TPN bag material, the ambient temperature, and the length of time between TPN compounding and the end of infusion to the patient.

Ascorbic Acid↗
PubMedDate not supplied

Is nutritional depletion by Nutritional Risk Index associated with increased length of hospital stay? A population-based study.

BACKGROUND: Malnutrition is common at hospital admission and tends to worsen during hospitalization. This controlled population study aimed to determine if serum albumin or moderate and severe nutritional depletion by Nutritional Risk Index (NRI) at hospital admission are associated with increased length of hospital stay (LOS) (and increased hospital cost) in patients admitted to hospitals in 2 European countries. METHODS: Serum albumin levels and recent weight loss were prospectively determined at hospital admission in Geneva (n = 652) and Berlin (n = 621). Patients were classified as no, mild, moderate or severe risk by NRI. Multiple logistic regressions were used to determine the association between albumin and nutritional risk category and LOS. RESULTS: Patients (24%) were at moderate or severe nutritional risk by NRI. Nutritional risk by NRI, adjusted for age, was associated with LOS of 11 days (moderate: odds ratio [OR] 1.9, 95% confidence interval [CI] 1.4 to 2.7, p < .005; severe: OR 2.9, 95% CI 1.6 to 5.3, p < .005). Serum albumin was also significantly associated with increased LOS (p < .001). CONCLUSIONS: The prevalence of nutritional depletion assessed by NRI and albumin was increased with longer LOS. Albumin alone underestimated nutritional risk. Severe nutritional depletion by NRI was significantly associated with LOS > or = 11 days in Geneva and Berlin patients. Nutrition screening should take place at hospital admission to determine nutritional risk and risk for longer LOS.

Aged↗