Detection of capillary protein leakage by indocyanine green and glucose dilutions in septic patients.
OBJECTIVE
To determine whether indocyanine green (ICG) and glucose dilutions can detect generalized capillary protein leakage in septic patients without requiring repeated measurements.


METHODS
Prospective, clinical study.


METHODS
General intensive care unit.


METHODS
Twelve consecutive patients who met the criteria of sepsis and 16 consecutive acute myocardial infarction (AMI) patients without any underlying pathology inducing generalized protein capillary leakage.


METHODS
Both ICG 25 mg and glucose 5 g were administered simultaneously, to calculate the plasma volume determined by the ICG dilution method (PV-ICG) and the initial distribution volume of glucose (IDVG), on day 1 of sepsis or on day 1 of hospitalization for the AMI patients. The relationship between these two volumes and the PV-ICG/IDVG ratio was evaluated in two patient groups.


RESULTS
Although the IDVG of the two patient groups was not statistically different, the PV-ICG in the septic patients was higher than that in the AMI patients (p < .01). Consequently, the PV-ICG/IDVG ratio in the septic patients was higher than that in the AMI patients (p < .01). Eight of the 12 septic patients had a PV-ICG/IDVG ratio of >0.45, which was not observed in any of the AMI patients. The PV-ICG/IDVG ratio in the septic patients correlated inversely with the total plasma protein concentration (r2 = .46, p < .025) and mean arterial pressure (r2 = .42, p < .05).


CONCLUSIONS
Our results indicate that overestimation of the PV-ICG can occur in septic patients and, further, suggest that simultaneous measurement of the two distribution volumes would help predict generalized capillary protein leakage in septic patients without repeated measurement.
Ishihara
H
H
Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki-Shi, Japan. ishihara@cc.hirosaki-u.ac.jp
Matsui
A
A
Muraoka
M
M
Tanabe
T
T
Tsubo
T
T
Matsuki
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019559:Capillary Leak Syndrome / Q000175:diagnosis* / Q000209:etiology; D004396:Coloring Agents; D005110:Extracellular Space; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D010953:Plasma Volume; D011446:Prospective Studies; D012044:Regression Analysis; D018805:Sepsis / Q000150:complications*; D018709:Statistics, Nonparametric
D004396:Coloring Agents; D007208:Indocyanine Green; D005947:Glucose