Relation between indocyanine green (ICG) plasma disappearance rate and ICG blood clearance in critically ill patients.
OBJECTIVE
In contrast to indocyanine green (ICG) blood clearance, the plasma disappearance rate (PDR) of ICG does not require absolute ICG blood concentrations and today can be assessed transcutaneously. In this study, we analyzed the relation between ICG disappearance rate and ICG blood clearance as parameters of liver function in critically patients.


METHODS
Observational, clinical study. Retrospective analysis.


METHODS
Operative intensive care unit of a university hospital.


METHODS
209 patients (139 male, 70 female, age 10-88 years, 53+/-19 years) who underwent liver function monitoring for clinical indication. Patients suffered from sepsis (n=99), acute respiratory distress syndrome (n=31), severe head injury (n=38), hemorrhagic shock (n=19), intracranial hemorrhage (n=19), and cerebral infarction (n=3). All patients were sedated and mechanically ventilated via an endotracheal tube.


RESULTS
All patients were monitored by the transpulmonary double-indicator (thermo-dye dilution) technique using a thermistor and calibrated fiber-optic system (Pulsiocath 4F, PV 2024L, Pulsion Medical Systems, Munich, Germany). For each measurement, a dosage of 0.3 mg/kg ICG was injected central-venously. Transpulmonary ICG concentration curves were analyzed automatically using a computer system (COLD-Z021, Pulsion Medical Systems, Munich, Germany). By using the first ICG measurement in each patient after admission to the ICU, we analyzed 209 pairs of ICG disappearance rate and ICG blood clearance. Linear regression analysis revealed a correlation of r2=0.77 between ICG-PDR and ICG blood clearance.


CONCLUSIONS
ICG-PDR does reflect ICG blood clearance with sufficient accuracy in critically ill patients and may be used as a surrogate.
Department of Anesthesiology and Intensive Care Medicine, Friedrich-Schiller-University of Jena, Erlanger Allee 101, 07740, Jena, Germany. Samir.Sakka@med.uni-jena.de
Samir G
SG
Sakka
Nicole
N
van Hout
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016638:Critical Illness; D005260:Female; D005858:Germany; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage / Q000032:analysis* / Q000493:pharmacokinetics; D008111:Liver Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012189:Retrospective Studies
D007208:Indocyanine Green