The role of non-invasive bioelectrical impedance analysis (BIA) in targeted fluid therapy of patients with severe traumatic brain injury: a clinical case

The main causes of death in patients with polytrauma remain traumatic brain injury (TBI) and uncontrolled bleeding with trauma-induced coagulopathy (TIC) [1].Moreover, patients with severe TBI (Glasgow Coma Scale, GCS ≤8) require targeted infusion therapy (TIT), since, according to the results of the studies, a positive fluid balance was associated with worse survival and worse treatment outcomes in this category of patients [2]. Traditionally, the concept of CIT is implemented using invasive techniques (e.g. PiCCO), however, recently there has been a growing interest in non-invasive monitoring tools, one of which is bioelectrical impedance analysis (BIA). BIA allows us to assess the patient‘s volume status, the distribution of fluid between the body‘s sectors, identify hypo- and hypervolemia, and thus indirectly assess changes in the water content in tissues, including the brain.In the context of CIT, BIA parameters can be used to make decisions about the volume, quality and rate of infusion therapy in critically ill patients in the neurointensive care unit [3].

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