Bioimpedance for peripheral edema assessment in heart failure and clinical practice: a systematic review

<i>Objective.</i>Peripheral edema is a common issue among elderly individuals with chronic conditions such as heart failure (HF). Continuous, non-invasive monitoring may enable earlier intervention, reduced hospital readmissions, and improved quality of life. This systematic review aims to evaluate the use of bioimpedance (BI) as a method for monitoring peripheral edema, with a particular focus on portable and wearable applications for remote health management.<i>Approach.</i>A systematic search was conducted across PubMed, IEEE Xplore, and Web of Science to identify studies utilizing BI for the detection or monitoring of lower limb edema with potential for portability or wearability.<i>Main results.</i>Fourteen studies met the inclusion criteria. Five studies focused on HF patients, while nine involved other populations, such as healthy individuals, patients with limb injuries, or those on hemodialysis. Ten studies featured or proposed portable BI devices, whereas four remained at the proof-of-concept stage without portable implementations. There was significant variability in device design, measurement protocols, and target populations. While existing results show promise, few studies evaluated systems in real-world or long-term monitoring scenarios.<i>Significance.</i>BI is a promising, non-invasive approach for the continuous monitoring of peripheral edema, particularly in remote and home-based settings. However, current research is limited by small sample sizes, lack of standardization, and minimal validation in diverse, real-world environments. Further development of wearable systems and robust clinical validation is essential to support broader clinical adoption.