{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T20:22:51Z","timestamp":1768335771967,"version":"3.49.0"},"reference-count":53,"publisher":"Institute of Physiology of the Czech Academy of Sciences","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Critically ill patients often experience hyperhydration and muscle wasting, which can worsen outcomes. This study evaluated the feasibility of using bioelectrical impedance vector analysis (BIVA) to monitor hydration and muscle mass and predict outcomes in COVID-19 patients with acute respiratory distress syndrome (ARDS), including those with extracorporeal membrane oxygenation (ECMO). The study compare fluid parameters derived from BIVA with cumulative fluid balance (CFB) and assess the prognostic value of the phase angle (PA) of BIVA against established markers such an APACHE II and serum presepsin. In this prospective, blinded observational study, 61 COVID-19 patients on invasive mechanical ventilation (IMV) were included. BIVA measurements were taken within 48 h of admission, then after 7 and 14 days. Data on demographics, fluid balance, and laboratory markers were collected. BIVA was shown to be feasible in critically ill patients, with a significant correlation between hyperhydration, defined by an elevated extracellular water to total body water ratio (ECW\/TBW 0.56) and overhydration (OHY 6.9 l). Decreased PA (median 3.3\u00b0) was associated with increased mortality in non-ECMO patients. Unlike CFB, which lacked statistical significance, BIVA provided a more accurate assessment of hyperhydration (p=0.0050 for ECW\/TBW and p=0.0402 for OHY). In conclusion, BIVA is a practical tool for monitoring hydration, but not muscle mass, in critically ill patients. Elevated hydration status and low PA measured by BIVA are effective predictors of mortality, although ECMO use can affect accuracy. ClinicalTrials.gov ID NCT04758676 (www.clinicaltrials.gov).<\/jats:p>","DOI":"10.33549\/physiolres.935748","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T13:48:57Z","timestamp":1768312137000},"page":"S93","source":"Crossref","is-referenced-by-count":0,"title":["Bioelectrical Impedance in Monitoring Hyperhydration and Muscle Wasting in Critically Ill Corona Virus Disease (COVID-19) Patients: The Feasibility of Predicting Outcome"],"prefix":"10.33549","author":[{"given":"M","family":"K\u00e1\u0148ov\u00e1","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Pet\u0159ekov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Borzenko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Ruskov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Nytra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Dzur\u0148\u00e1kov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Burda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Konvi\u010dka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"19169","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"1.\tVincent JL. Fluid management in the critically ill. Kidney Int 2019;96:52-57. https:\/\/doi.org\/10.1016\/j.kint.2018.11.047","DOI":"10.1016\/j.kint.2018.11.047"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"2.\tMichael PW, Mythen MG, Gan TJ. Perioperative Fluid Management and Clinical Outcomes in Adults. Anaesth Analg 2005;100:1093-1106. https:\/\/doi.org\/10.1213\/01.ANE.0000148691.33690.AC","DOI":"10.1213\/01.ANE.0000148691.33690.AC"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"3.\tPayen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008;12:R74. https:\/\/doi.org\/10.1186\/cc6916","DOI":"10.1186\/cc6916"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"4.\tRENAL Replacement Therapy Study Investigators, Bellomo R, Cass A, Cole L, Finfer S, Gallagher M, Lee J, et al. An observational study fluid balance and patient outcomes in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy trial. Crit Care Med 2012;40:1753-1760. https:\/\/doi.org\/10.1097\/CCM.0b013e318246b9c6","DOI":"10.1097\/CCM.0b013e318246b9c6"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"5.\tNational Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, de Boisblanc B, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006;354:2564-2575. https:\/\/doi.org\/10.1056\/NEJMoa062200","DOI":"10.1056\/NEJMoa062200"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"6.\tMagder S. Volume and its relationship to cardiac output and venous return. Crit Care 2016;20:271. https:\/\/doi.org\/10.1186\/s13054-016-1438-7","DOI":"10.1186\/s13054-016-1438-7"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"7.\tDe Backer D, Aissaoui N, Cecconi M, Chew MS, Denault A, Hajjar L, Hernandez G, et al. How can assessing hemodynamics help to assess volume status? Intensive Care Med 2022;48:1482-1494. https:\/\/doi.org\/10.1007\/s00134-022-06808-9","DOI":"10.1007\/s00134-022-06808-9"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"8.\tMichard F, Teboul JL. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 2002;121:2000-2008. https:\/\/doi.org\/10.1378\/chest.121.6.2000","DOI":"10.1378\/chest.121.6.2000"},{"key":"ref8","unstructured":"9.\tPerren A, Markmann M, Merlani G, Marone C, Merlani P. Fluid balance in critically ill patients. Should we really rely on it? Minerva Anestesiol 2011;77:802-811."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"10.\tStevenson LW, Perloff JK. The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA 1989;261:884-888. https:\/\/doi.org\/10.1001\/jama.1989.03420060100040","DOI":"10.1001\/jama.1989.03420060100040"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"11.\tPreiser JC, Ichai C, Orban JC, Groeneveld ABJ. Metabolic response to stress of criticall illness. Br J Anaesth 2014;113:945-954. https:\/\/doi.org\/10.1093\/bja\/aeu187","DOI":"10.1093\/bja\/aeu187"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"12.\tKress JP, Hall JB. ICU-acquired weakness and recovery from criticall illness. N Engl J Med 2014;370:1626-1635. https:\/\/doi.org\/10.1056\/NEJMra1209390","DOI":"10.1056\/NEJMra1209390"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"13.\tCurz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruy\u00e9re O, Cederholm T, Cooper C, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48:16-31. https:\/\/doi.org\/10.1093\/ageing\/afy169","DOI":"10.1093\/ageing\/afz046"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"14.\tBinkovitz LA, Henwood MJ. Pediatric DXA: technique and interpretation. Pediatr Radiol 2007;37:21-31. https:\/\/doi.org\/10.1007\/s00247-006-0153-y","DOI":"10.1007\/s00247-006-0153-y"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"15.\tAbramowitz MK, Hall CB, Amodu A, Sharma D, Androga L, Hawkins M. Muscle mass, BMI, and mortality among adults in the United States: A population-based cohort study. PLoS One 2018;13:e0194697. https:\/\/doi.org\/10.1371\/journal.pone.0194697","DOI":"10.1371\/journal.pone.0194697"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"16.\tMalbrain MLNG, Huygh J, Dabrowski W, De Waele JJ, Staelens A, Wauters J. The use of bio-electrical impedance analysis (BIA) to guide fluid management, resuscitation and deresuscitation in critically ill patients: a bench-to-bedside review. Anaesthesiol Intensive Ther 2014;46:381-391. https:\/\/doi.org\/10.5603\/AIT.2014.0061","DOI":"10.5603\/AIT.2014.0061"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"17.\tMoissl UM, Wabel P, Chamney PW, Bosaeus I, Levin NW, Bosy-Westphal A, Korth O, et al. Body fluid volume determination via body composition spectroscopy in health and disease. Physiol Meas 2006;27:921-933. https:\/\/doi.org\/10.1088\/0967-3334\/27\/9\/012","DOI":"10.1088\/0967-3334\/27\/9\/012"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"18.\tKhalil SF, Mohktar MS, Ibrahim F. The Theory and Fundamentals of Bioimpedance Analysis in Clinical Status Monitoring and Diagnosis of Diseases. Sensors 2014;14:10895-10928. https:\/\/doi.org\/10.3390\/s140610895","DOI":"10.3390\/s140610895"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"19.\tFujimoto K, Inage K, Eguchi Y, Orita S, Suzuki M, Kubota G, Sainoh T, et al. Use of bioelectrical impedance analysis for the measurement of appendicular skeletal muscle mass\/whole fat mass and its relevance in assessing osteoporosis among patients with low back pain: a comparative analysis using dual x-ray absorptiometry. Asian Spine J 2018;12:839-845. https:\/\/doi.org\/10.31616\/asj.2018.12.5.839","DOI":"10.31616\/asj.2018.12.5.839"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"20.\tCheng KY-K, Chow SK-H, Hung VW-Y, Wong CH-W, Wong RM-Y, Tsang CS-L, Kwok T, et al. Diagnosis of sarcopenia by evaluating skeletal muscle mass by adjusted bioimpedance analysis validated with dual\u2010energy X\u2010ray absorptiometry. J Cachexia Sarcopenia Muscle 2021;12:2163-2173. https:\/\/doi.org\/10.1002\/jcsm.12825","DOI":"10.1002\/jcsm.12825"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"21.\tDzator S, Weerasekara I, Shields M, Haslam R, James D. Agreement Between Dual-Energy X-ray Absorptiometry and Bioelectric Impedance Analysis for Assessing Body Composition in Athletes: A Systematic Review and Meta-Analysis. Clin J Sport Med 2023;33:557-568. https:\/\/doi.org\/10.1097\/JSM.0000000000001136","DOI":"10.1097\/JSM.0000000000001136"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"22.\tBaumgartner RN, Chumlea WC, Roche AF. Bioelectrical impedance phase angle and body composition. Am J Clin Nutr 1988;48:16-23. https:\/\/doi.org\/10.1093\/ajcn\/48.1.16","DOI":"10.1093\/ajcn\/48.1.16"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"23.\tGupta D, Lis CG, Dahlk SL, Vashi PG, Grutsch JF, Lammersfeld CA. Bioelectrical impedance phase ange as a prognostic indicator in advanced pancreatec cancer. Br J Nutr 2004;92:957-962. https:\/\/doi.org\/10.1079\/BJN20041292","DOI":"10.1079\/BJN20041292"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"24.\tGupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL, Grutsch J, Lis GG. Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. BMC Cancer 2008;8:249. https:\/\/doi.org\/10.1186\/1471-2407-8-249","DOI":"10.1186\/1471-2407-8-249"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"25.\tK\u00e1\u0148ov\u00e1 M, Dobi\u00e1\u0161 R, Liszkov\u00e1 K, Frelich M, Je\u010dm\u00ednkov\u00e1 R, Kula R. Presepsin in the diagnostics of sepsis. Vnitr Lek 2019;65:497-505. https:\/\/doi.org\/10.36290\/vnl.2019.087","DOI":"10.36290\/vnl.2019.087"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"26.\tBehnes M, Bertsch T, Lepiorz D, Lang S, Trinkmann F, Brueckmann M, Borggrefe M, et al. Diagnostic and prognostic utility of soluble CD 14 subtype (presepsin) for severe sepsis and septic shock during the first week of intensive care treatment. Crit Care 2014;18:507. https:\/\/doi.org\/10.1186\/s13054-014-0507-z","DOI":"10.1186\/s13054-014-0507-z"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"27.\tSilva MJA, Ribeiro LR, Gouveia MIM, Marcelino BDR, Santos CSD, Lima KVB, Lima LNGC. Hyperinflammatory Response in COVID-19: A Systematic Review. Viruses 2023;15:553. https:\/\/doi.org\/10.3390\/v15020553","DOI":"10.3390\/v15020553"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"28.\tCornejo-Pareja I, Vegas-Aguilar IM, Lukaski H, Talluri A, Bellido-Guerrero D, Tinahones FJ, Garc\u00eda-Almeida JM. Overhydration Assessed Using Bioelectrical Impedance Vector Analysis Adversely Affects 90-Day Clinical Outcome among SARS-CoV2 Patients: A New Approach. Nutrients 2022;14:2726. https:\/\/doi.org\/10.3390\/nu14132726","DOI":"10.3390\/nu14132726"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"29.\tOsuna-Padilla IA, Rodr\u00edguez-Moguel NC, Rodr\u00edguez-Llamazares S, Aguilar-Vargas A, Casas-Aparicio GA, R\u00edos-Ayala MA, Hern\u00e1ndez-Cardenas CM. Low Phase Angle Is Associated with 60-Day Mortality in Critically Ill Patients with COVID-19. J Parenter Enter Nutr 2021;46:828-835. https:\/\/doi.org\/10.1002\/jpen.2236","DOI":"10.1002\/jpen.2236"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"30.\tLukaski HC, Vega Diaz N, Talluri A, Nescolarde L. Classification of Hydration in Clinical Conditions: Indirect and Direct Approaches Using Bioimpedance. Nutrients 2019;11:809. https:\/\/doi.org\/10.3390\/nu11040809","DOI":"10.3390\/nu11040809"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"31.\tMoonen HPFX, Van Zanteen ARH. Bioelectric impedance analysis for body composition meassurement and other potential clinical applications in critical illness. Curr Opin Crit Care 2021;27:344-353. https:\/\/doi.org\/10.1097\/MCC.0000000000000840","DOI":"10.1097\/MCC.0000000000000840"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"32.\tChamney PW, Wabel P, Moissl UM, M\u00fcller MJ, Bosy-Westphal A, Korth O, Fuller NJ. A whole-body model to distinguish excess fluid from the hydration of major body tissues. Am J Clin Nutr 2007;85:80-89. https:\/\/doi.org\/10.1093\/ajcn\/85.1.80","DOI":"10.1093\/ajcn\/85.1.80"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"33.\tPiccoli A, Codognotto M, Piasentin P, Naso A. Combined evaluation of nutrition and hydration in dialysis patients with bioelectrical impedance vector analysis (BIVA). Clin Nutr 2014;33:673-677. https:\/\/doi.org\/10.1016\/j.clnu.2013.08.007","DOI":"10.1016\/j.clnu.2013.08.007"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"34.\tPeacock IV WF. Use of bioimpedance vector analysis in critically ill and cardiorenal patients. Contrib Nephrol 2010;165:226-235. https:\/\/doi.org\/10.1159\/000313762","DOI":"10.1159\/000313762"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"35.\tFinn PJ, Plank LD, Clark MA, Connolly AB, Hill GL. Progressive cellular dehydration and proteolysis in critically ill patients. Lancet 1996;347:654-656. https:\/\/doi.org\/10.1016\/S0140-6736(96)91204-0","DOI":"10.1016\/S0140-6736(96)91204-0"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"36.\tPlank LD, Monk DN, Woollard GA, Hill GL. Evaluation of multifrequency bioimpedance spectroscopy for measurement of the extracellular water space in criticall ill patients. Appl Radiat Isot 1998;49:481-483. https:\/\/doi.org\/10.1016\/S0969-8043(97)00060-2","DOI":"10.1016\/S0969-8043(97)00060-2"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"37.\tRhee H, Jang KS, Shin MJ, Lee JW, Kim IY, Song SH, Lee DW, et al. Use of multifrequency bioimpedance analysis in male patients with acute kidney injury who are undergoing continuous veno-venous hemodiafiltration. PLoS One 2015;10:e0133199. https:\/\/doi.org\/10.1371\/journal.pone.0133199","DOI":"10.1371\/journal.pone.0133199"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"38.\tDewitte A, Carles P, Joann\u00e8s-Boyau O, Fleureau C, Roze H, Combe C, Outtara A. Bioelectrical impedance spectroscopy to estimate fluid balance in critically ill patients. J Clin Monit Comput 2016;30:227-233. https:\/\/doi.org\/10.1007\/s10877-015-9706-7","DOI":"10.1007\/s10877-015-9706-7"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"39.\tYang SF, Tseng CM, Liu IF, Tsai SH, Kuo WS, Tsao TP. Clinical significance of bioimpedance spectroscopy in critically ill patients. J Intensive Care Med 2019;34:495-502. https:\/\/doi.org\/10.1177\/0885066617702591","DOI":"10.1177\/0885066617702591"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"40.\tParrinello G, Paterna S, Di Pasquale P, Torres D, Fatta A, Mezzero M, Scaglione R, et al. The usefulness of bioelectrical impedance analysis in differentiating dyspnea due to decompensated heart failure. J Card Fail 2008;14:676-686. https:\/\/doi.org\/10.1016\/j.cardfail.2008.04.005","DOI":"10.1016\/j.cardfail.2008.04.005"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"41.\tDi Somma S, Lalle I, Magrini L, Russo V, Navarin S, Castello L, Avanzi GC, Di Stasio E, et al. Additive diagnostic and prognostic value of bioelectrical impedance vector analysis (BIVA) to brain natriuretic peptide 'grey-zone' in patients with acute heart failure in the emergency department. Eur Heart J Acute Cardiovasc Care 2014;3:167-175. https:\/\/doi.org\/10.1177\/2048872614521756","DOI":"10.1177\/2048872614521756"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"42.\tDabrowski W, Kotlinska-Hasiec E, Schneditz D, Zaluska W, Rzecki Z, De Keulenaer B, Malbrain ML. Continuous veno-venous hemofiltration to adjust fluid volume excess in septic shock patients reduces intra-abdominal pressure. Clin Nephrol 2014;82:41-50. https:\/\/doi.org\/10.5414\/CN108015","DOI":"10.5414\/CN108015"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"43.\tMalbrain MLNG, Marik PE, Witters I, Cordemans C, Kirkpatrick AW, Roberts DJ, Van Regenmortel N. Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: a systematic review with suggestions for clinical practice. Anaesthesiol Intensive Ther 2014;46:361-380. https:\/\/doi.org\/10.5603\/AIT.2014.0060","DOI":"10.5603\/AIT.2014.0060"},{"key":"ref43","unstructured":"44.\tGulatava N, Tabagari N, Tabagari S. Bioelectrical impendance analysis of body composition in patients with chronic heart failure. Georgian Med News 2021;315:94-98."},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"45.\tWang Y, Gu Z. Effect of bioimpedance-defined overhydration parameters on mortality and cardiovascular events in patients undergoing dialysis: a systematic review and meta-analysis. J Int Med Res 2021;49:3000605211031063. https:\/\/doi.org\/10.1177\/03000605211031063","DOI":"10.1177\/03000605211031063"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"46.\tPark CS, Lee SE, Cho H-J, Kim Y-J, Kang H-J, Oh B-H, Lee H-Y. Body fluid status assessment by bio-impedance analysis in patients presenting to the emergency department with dyspnea. Korean J Intern Med 2018;33:911-921. https:\/\/doi.org\/10.3904\/kjim.2016.358","DOI":"10.3904\/kjim.2016.358"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"47.\tSlobod D, Yao H, Mardini J, Natkaniec J, Correa JA, Jayaraman D, Weber CL. Bioimpedance-measured volume overload predicts longer duration of mechanical ventilation in intensive care unit patients. Can J Anesth 2019;66:1458-1463. https:\/\/doi.org\/10.1007\/s12630-019-01450-4","DOI":"10.1007\/s12630-019-01450-4"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"48.\tTanaka S, Ando K, Kobayashi K, Seki T, Hamada T, Machino M, Ota K, et al. Low Bioelectrical Impedance Phase Angle Is a Significant Risk Factor for Frailty. Biomed Res Int 2019;2019:6283153. https:\/\/doi.org\/10.1155\/2019\/6283153","DOI":"10.1155\/2019\/6283153"},{"key":"ref48","doi-asserted-by":"crossref","unstructured":"49.\tLooijaard WGPM, Stapel SN, Dekker IM, Rusticus H, Remmelzwaal S, Girbes ARJ, Weijs PJM, et al. Identifying critically ill patients with low muscle mass: Agreement between bioelectrical impedance analysis and computed tomography. Clin Nutr 2020;39:1809-1817. https:\/\/doi.org\/10.1016\/j.clnu.2019.07.020","DOI":"10.1016\/j.clnu.2019.07.020"},{"key":"ref49","doi-asserted-by":"crossref","unstructured":"50.\tLorenzo I, Serra-Prat M, Y\u00e9benes JC. The Role of Water Homeostasis in Muscle Function and Frailty: A Review. Nutrients 2019;11:1857. https:\/\/doi.org\/10.3390\/nu11081857","DOI":"10.3390\/nu11081857"},{"key":"ref50","doi-asserted-by":"crossref","unstructured":"51.\tBagshaw SM, Brophy PD, Cruz D, Ronco C. Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury. Crit Care 2008;12:169. https:\/\/doi.org\/10.1186\/cc6948","DOI":"10.1186\/cc6948"},{"key":"ref51","doi-asserted-by":"crossref","unstructured":"52.\tFarokhi FR, Kalateh E, Shafaghi S, Schneider AG, Mortazavi SM, Jamaati H, Hashemian SMR. Applying bio-impedance vector analysis (BIVA) to adjust ultrafiltration rate in critically ill patients on continuous renal replacement therapy: a randomized controlled trial. J Crit Care 2022;72:154146. https:\/\/doi.org\/10.1016\/j.jcrc.2022.154146","DOI":"10.1016\/j.jcrc.2022.154146"},{"key":"ref52","doi-asserted-by":"crossref","unstructured":"53.\tPark CH, Koh HB, Lee JH, Jung H-Y, Ha J, Kim HW, Park JT, et al. Volume control strategy and patient survival in sepsis-associated acute kidney injury receiving continuous renal replacement therapy: a randomized controlled trial with secondary analysis. Sci Rep 2024;14:14284. https:\/\/doi.org\/10.1038\/s41598-024-64224-z","DOI":"10.1038\/s41598-024-64224-z"}],"container-title":["Physiological Research"],"original-title":[],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T13:49:25Z","timestamp":1768312165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biomed.cas.cz\/physiolres\/pdf\/2025\/74_S93.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":53,"URL":"https:\/\/doi.org\/10.33549\/physiolres.935748","relation":{},"ISSN":["0862-8408","1802-9973"],"issn-type":[{"value":"0862-8408","type":"print"},{"value":"1802-9973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}