Detection of capillary protein leakage by indocyanine green and glucose dilutions in septic patients

Abstract

Our results indicate that overestimation of the PV-ICG can occur in septic patients and, further, suggest that simultaneous measurement of the two distribution volumes would help predict generalized capillary protein leakage in septic patients without repeated measurement.

The initial distribution volume of glucose rather than indocyanine green derived plasma volume is correlated with cardiac output following major surgery

“…Considering the pharmacokinetic behavior of intravenously administered glucose, IDVG does not directly indicate circulating blood volume or left ventricular end-diastolic volume. However, IDVG was more closely correlated with CI than PV-ICG or BV-ICG in this study, as has been observed previously [11,12], although the precision of continuous thermodilution cardiac output measurements has been reported to be less than iced bolus thermodilution cardiac output measurements [24]. This can be partly explained by the fact that circu- Fig.…”

“…Leakage can occur during various pathological conditions including major surgical stress [28]. We have recently proposed that the PV-ICG/IDVG ratio can help to predict overestimation of PV-ICG in critically ill patients and experimental animals [11,12,21,29]. A ratio higher than 0.45 in humans may indicate the presence of an overestimation, although a higher ratio cannot consistently rule out the presence of central hypovolemia associated with peripheral blood pooling [26].…”

“…IDVG is also correlated with cardiac output in hypovolemic dogs [14] and critically ill patients without congestive heart failure [15]. Additionally, our previous studies have suggested that IDVG rather than plasma volume determined by the indocyanine green (ICG) dilution method (PV-ICG) has a better linear correlation with cardiac output in burned patients and acute myocardial infarction patients [11,12]. However, both a small sampling size and a lack of body size correction in these studies prevented us from reaching consistent results.…”

“…The distribution volume of rapidly exchanging glucose pools is not altered by insulin in humans [6,7]. We have proposed that the initial distribution volume of glucose (IDVG), which mirrors rapidly exchanging glucose pools, indicates the extracellular fluid volume status of plasma and the highly perfused interstitial fluid compartment in various pathological conditions without a significant modification in glucose metabolism [8,9,10,11,12,13]. IDVG is also correlated with cardiac output in hypovolemic dogs [14] and critically ill patients without congestive heart failure [15].…”

Idiopathic Systemic Capillary Leak Syndrome: Cutaneous Involvement Can Be Misleading

“…Biologically, an increased haematocrit contrasts with a low level of albumin. SCLS is usually associated with sepsis [1, 2], haematological diseases [3, 4]or medication intake (interleukin 2, tumour necrosis factor α, GM-CSF...) [5, 6, 7, 8]. Some cases of SCLS without evident aetiology are reported as idiopathic (ISCLS).…”