title: Determination of total blood volume by indicator dilution: a comparison of mean transit time and mass conservation principle.
abstract: OBJECTIVE
  Using indocyanine green (ICG), blood volume can be determined within minutes according to the mass conservation principle by back-extrapolation of the concentration/time curve to the time of injection (BVTinj) or by the transit time approach (BVMTT) as the product of cardiac output and mean transit time (MTT) of ICG through the circulation. To see which factor accounts for the difference between the two methods we measured cardiac output and MTT independently and compared the volumes with those obtained by dilution of Evans blue (BVEB).
  
  
  METHODS
  Prospective animal study.
  
  
  METHODS
  University department of experimental anaesthesiology.
  
  
  METHODS
  Six anaesthetised, spontaneously breathing dogs with chronically implanted ultrasound flow probes around the pulmonary artery.
  
  
  RESULTS
  BVMTT and BVTinj agreed closely (48 +/- 2 ml.kg-1 and 49 +/- 2 ml.kg-1), but underestimated blood volume by about 40% compared with BVEB (75 +/- 1 ml.kg-1). Transit times measured were 33 +/- 1 s and should be about 50 s as calculated from the quotient of BVEB and cardiac output.
  
  
  CONCLUSIONS
  Both methods underestimate blood volume by about the same extent compared with BVEB, probably because slowly perfused compartments are not detected during the short measurement period of 4 min. In the case of the transit time approach, rather short transit times result and in the case of the mass conservation principle, back-extra-polation yields rather high plasma concentrations of ICG at the time of injection. Accordingly, the two methods seem to be equivalent for measuring blood volume rapidly, although the absolute volume is underestimated by about 40%.
authors.affiliation: Department of Experimental Anaesthesiology, Heinrich-Heine-University, Moorenstrasse 5, 40225 Düsseldorf, Germany. olaf.picker@uni-duesseldorf.de
authors.forename: O
authors.initials: O
authors.lastname: Picker
authors.forename: G
authors.initials: G
authors.lastname: Wietasch
authors.forename: T W
authors.initials: TW
authors.lastname: Scheeren
authors.forename: J O
authors.initials: JO
authors.lastname: Arndt
mesh_terms: D000818:Animals; D001692:Biological Transport; D001776:Blood Circulation Time; D001811:Blood Volume Determination / Q000379:methods; D002302:Cardiac Output / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D004285:Dogs; D005070:Evans Blue / Q000032:analysis / Q000494:pharmacology*; D005260:Female; D007201:Indicator Dilution Techniques; D007208:Indocyanine Green / Q000032:analysis / Q000494:pharmacology*; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D005070:Evans Blue; D007208:Indocyanine Green