title: Indocyanine green kinetics characterize blood volume and flow distribution and their alteration by propranolol.
abstract: OBJECTIVE
  Although indocyanine green can be used to estimate cardiac output and blood volume independently, a recirculatory multicompartmental indocyanine green model enables description of these and additional intravascular events. Our model was used to describe the effect of propranolol on blood volume and flow distribution in humans.
  
  
  METHODS
  Indocyanine green disposition was determined twice in four healthy adult men, once during a propranolol infusion that decreased cardiac output. After injection of indocyanine green, arterial blood was collected frequently for 2 minutes and less frequently thereafter. Plasma indocyanine green concentrations were measured by HPLC. The recirculatory pharmacokinetic model incorporates data from both the initial transient oscillations and the later post-mixing portions of the blood indocyanine green concentration versus time curves to characterize not only blood volume and cardiac output but also their distribution among a central blood volume and fast and slow peripheral volumes in lumped parallel circuits. Flow through the central circulation (cardiac output) is described by two parallel Erlang distribution functions generated by two linear chains of compartments in parallel.
  
  
  RESULTS
  Propranolol reduced cardiac output from 10.6 to 4.1 L/min. Most of the decrease in cardiac output was at the expense of blood flow to the fast peripheral circuit, which represented nonsplanchnic circulation. Propranolol also reduced the blood volume of the fast peripheral circuit by more than half.
  
  
  CONCLUSIONS
  Our indocyanine green model is able to derive estimates of blood volume and cardiac output, as well as their systemic distribution during different physiologic conditions.
authors.affiliation: Department of Anesthesiology, Northwestern University Medical School, Chicago, IL 60611-3008, USA.
authors.forename: C U
authors.initials: CU
authors.lastname: Niemann
authors.forename: T K
authors.initials: TK
authors.lastname: Henthorn
authors.forename: T C
authors.initials: TC
authors.lastname: Krejcie
authors.forename: C A
authors.initials: CA
authors.lastname: Shanks
authors.forename: C
authors.initials: C
authors.lastname: Enders-Klein
authors.forename: M J
authors.initials: MJ
authors.lastname: Avram
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000097:blood / Q000494:pharmacology*; D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D001810:Blood Volume / Q000187:drug effects; D002851:Chromatography, High Pressure Liquid; D004396:Coloring Agents / Q000493:pharmacokinetics*; D004347:Drug Interactions; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D008297:Male; D008657:Metabolic Clearance Rate; D011433:Propranolol / Q000097:blood / Q000494:pharmacology*
chemical_list: D000319:Adrenergic beta-Antagonists; D004396:Coloring Agents; D011433:Propranolol; D007208:Indocyanine Green