title: Indocyanine green clearance as an outcome prediction tool in cardiac surgery: a prospective study.
abstract: OBJECTIVE
  To evaluate the role of plasma disappearance rate of indocyanine green (PDR-ICG) as an outcome prediction tool in cardiac surgery.
  
  
  METHODS
  One hundred ninety patients undergoing coronary artery bypass grafting, valve surgery or combined procedures were enrolled. PDR-ICG measurements along with standard lab values were performed preoperative and on postoperative days 1, 2, and on discharge from the intensive care unit. Adverse outcomes were defined as prolonged length of stay in the intensive care unit and/or mortality. Two groups were defined according to length of stay in the intensive care unit (≤ 3 days vs >3 days).
  
  
  RESULTS
  PDR-ICG values differed significantly for all time points between the groups. In a multivariate model, in patients over 65 years with a EuroSCORE below 8.5, a preoperative PDR-ICG value below 12.85%/min was the strongest independent predictor for prolonged intensive care unit stay (>3 days). A preoperative PDR-ICG value below 8.2%/min was the strongest independent predictor for mortality in a multivariate analysis including age, cardiac function, and EuroSCORE.
  
  
  CONCLUSIONS
  In addition to the established scores, PDR-ICG may provide valuable information for the assessment of perioperative morbidity and mortality in cardiac surgery. Pre- and early postoperative measurements may help to identify patients at risk for developing perioperative complications.
authors: Department of Anesthesiology, Ludwig-Maximilians University, Munich, Germany.
authors: Florian
authors: F
authors: Weis
authors: Department of Anesthesiology, Ludwig-Maximilians University, Munich, Germany.
authors: Erich
authors: E
authors: Kilger
authors: Department of Cardiothoracic and Vascular Surgery, J.W. Goethe-University, Frankfurt, Germany.
authors: Andres
authors: A
authors: Beiras-Fernandez
authors: Department of Anesthesiology, Ludwig-Maximilians University, Munich, Germany.
authors: Christian L
authors: CL
authors: Hinske
authors: Department of Anesthesiology, Ludwig-Maximilians University, Munich, Germany.
authors: Kirsten
authors: K
authors: Nassau
authors: Department of Anesthesiology, Ludwig-Maximilians University, Munich, Germany.
authors: Lahib
authors: L
authors: Adnan
authors: Department of Cardiac Surgery, Ludwig-Maximilians University, Munich, Germany.
authors: Calin
authors: C
authors: Vicol
authors: Department of Cardiac Surgery, Ludwig-Maximilians University, Munich, Germany.
authors: Felix
authors: F
authors: Kur
authors: Department of Anesthesiology, Ludwig-Maximilians University, Munich, Germany. Electronic address: patrick.moehnle@med.uni-muenchen.de.
authors: Patrick
authors: P
authors: Möhnle
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality; D004396:Coloring Agents / Q000493:pharmacokinetics*; D001026:Coronary Artery Bypass / Q000401:mortality; D003325:Coronary Care Units; D005260:Female; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: Adverse outcome; Cardiac surgery; Hepatic dysfunction; Indocyanine green clearance