Improving the approach to end of life care

In a UK first, researchers from the Marie Curie Palliative Care Institute Liverpool, based at the University of Liverpool, have utilised a novel assessment tool to help monitor the hydration levels of a critically ill patient with POEMS syndrome to improve care. Hydration in critically ill patients is important and the accurate assessment of their fluid status can be challenging. For example, many people with advanced cancer may have less desire to drink as their condition worsens and we understand little of the effects of this both physiologically and clinically. Currently, there is a lack of evidence to guide health professionals' management of (de)hydration of critically ill patients and current methods for monitoring hydration status can be invasive. In addition, current methods can provide a flawed measurement of hydration as they provide no information about extravascular or intracellular fluid status. Feasibility and validity The study, which took place in the Royal Liverpool University Hospital in collaboration with Professor Andrew Pettitt , aimed to use bioelectrical impedance vector analysis (BIVA) to assist in guiding the care of a symptomatic patient with POEMS syndrome. Bioelectrical impedance vector analysis is a simple, safe, bedside method to measure body water content.