[Indocyanine green plasma disappearance rate. Marker of partial hepato-splanchnic ischemia].
Indocyanine green (ICG) is nearly exclusively eliminated from the blood by the liver and the ICG plasma disappearance rate (ICG-PDR) enables assessment of liver blood flow and function. The ICG-PDR which nowadays can be measured non-invasively by a transcutaneous system enables bedside and "on-line" regional monitoring in critically ill patients. So far, only complete lack of ICG-PDR as a sign of non-existing perfusion during liver transplantation has been reported. We describe two patients who developed mesenteric ischemia accompanied by an inadequate increase after revascularisation and an acute drop in the ICG-PDR. In both cases, a computed tomography scan was performed and confirmed an acute abdominal ischemia as indicated by ICG-PDR. Both patients suffered from occlusion of the truncus coeliacus while hepato-splanchnic perfusion via the A. mesenterica superior and the V. portae was maintained. ICG-PDR may be helpful for early detection of hepato-splanchnic ischemia and enables rapid and sufficient initiation of diagnostic and therapeutic procedures. In conclusion, ICG-PDR may be regarded as a clinically attractive bedside monitoring tool for early and reliable detection of partial ischemia in the hepato-splanchnic tract.
Thümer
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O
Klinik für Anästhesiologie und Intensivtherapie, Friedrich-Schiller-Universität Jena, Jena.
Hüttemann
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E
Sakka
S G
SG
D000005:Abdomen / Q000098:blood supply; D000368:Aged; D002637:Chest Pain / Q000209:etiology; D004396:Coloring Agents; D006801:Humans; D006973:Hypertension / Q000150:complications; D007208:Indocyanine Green; D007511:Ischemia / Q000175:diagnosis*; D008102:Liver Circulation / Q000502:physiology*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009862:Online Systems; D013152:Splanchnic Circulation / Q000502:physiology*; D014057:Tomography, X-Ray Computed
D004396:Coloring Agents; D007208:Indocyanine Green