Indocyanine Green: Evaluation of Liver Function — Application in Intensive Care Medicine

Kuntz, Hans-Dieter; Schregel, W.

doi:10.1007/978-3-642-75086-1_7

Cited by 15 publications

(7 citation statements)

References 16 publications

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“…Remarkably, PDR ICG in this study, with a maximum of 22.6% in the postoperative phase (Fig. 2), was slightly lower than the reported normal values (26±3% in healthy subjects [24]). However, PDR ICG and Cl ICG are interrelated by the amount of the circulating blood volume (see equation 5).…”

Section: Icg Plasma Disappearance Ratementioning

confidence: 53%

Perioperative monitoring of indocyanine green clearance and plasma disappearance rate in patients undergoing liver transplantation

Spiegel¹,

Scholz²,

Wietasch³

et al. 2002

Anaesthesist

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Section: Icg Plasma Disappearance Ratementioning

confidence: 53%

Perioperative monitoring of indocyanine green clearance and plasma disappearance rate in patients undergoing liver transplantation

Spiegel¹,

Scholz²,

Wietasch³

et al. 2002

Anaesthesist

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“…2,4 The ICG elimination test was originally invented to determine hepatic blood flow, but it is in fact an integrative measure of both hepatic perfusion and excretory function. [5][6][7] Therefore, ICG elimination testing has been used for the past 20 years in the context of hepatic resection 8 and to assess liver functional reserve in hepatic injury and septic states; in addition, it was found to be as accurate as more complex scores (e.g., APACHE II and SAPS II) with respect to outcome prediction. [9][10][11] Moreover, ICG elimination tests are intended to determine the suitability of a potential donor liver and to recognize early graft dysfunction resulting from, for example, primary delayed or nonfunction of the graft, technical complications, and acute or chronic graft rejection in the transplant setting.…”

Section: Introductionmentioning

confidence: 99%

“…Normal values for ICG blood clearance are considered to be >18%/min 6. Spectrophotometric Measurement of ICG in Urine Urine was collected for 115 to 210 min after injection of the dye.…”

mentioning

confidence: 99%

Indocyanine Green Plasma Disappearance Rate During the Anhepatic Phase of Orthotopic Liver Transplantation

Bruegger

Studer

Schmid

et al. 2008

Journal of Gastrointestinal Surgery

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Non-invasive pulse spectrophotometry to measure indocyanine green (ICG) elimination correlates well with the conventional invasive ICG clearance test. Nevertheless, the precision of this method remains unclear for any application, including small-for-size liver remnants. We therefore measured ICG plasma disappearance rate (PDR) during the anhepatic phase of orthotopic liver transplantation using pulse spectrophotometry. Measurements were done in 24 patients. The median PDR after exclusion of two outliers and two patients with inconstant signal was 1.55%/min (95% confidence interval [CI]=0.8-2.2). No correlation with patient age, gender, body mass, blood loss, administration of fresh frozen plasma, norepinephrine dose, postoperative albumin (serum), or difference in pre and post transplant body weight was detected. In conclusion, we found an ICG-PDR different from zero in the anhepatic phase, an overestimation that may arise in particular from a redistribution into the interstitial space. If ICG pulse spectrophotometry is used to measure functional hepatic reserve, the verified average difference from zero (1.55%/min) determined in our study needs to be taken into account.

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“…In our study the PDR after liver reperfusion comes close to normal values (20–30%) (30), in patients with good graft function (determined by clinical parameters). This represents an important innovation as against other reports, because it allows an early diagnosis of PGD and employment of methods to try to improve graft function (plasmapheresis, prostaglandins, etc) (31, 32) or accelerate the indication of re‐transplantation. Portal vein thrombosis also decreased PDR, and its diagnosis allows an early surgical correction.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic monitoring and liver function evaluation by pulsion cold system Z‐201 (PCS) during orthotopic liver transplantation

Díaz¹,

Pérez-Peña²,

Sanz³

et al. 2003

Clinical Transplantation

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Pulsion cold system (PCS, COLD) is a haemodynamic monitoring system that allows measurement of cardiac output (CO), partial blood volumes, lung water, and liver function. The aim of the study was to evaluate this monitoring system during human orthotopic liver transplantation (OLT) for the following: (a) to determine agreement between CO measurements via pulmonary artery thermodilution (CO TDpa), and aortic transpulmonary thermodilution (CO TDa); (b) to compare the preload dates obtained with the COLD with central venous pressure (CVP) and pulmonary capillary wedge (PCWP); and (c) to assess the use of the plasma disappearance rate (PDR) of indocyanine green (ICG) as a measure of graft function. Fifteen consecutive patients undergoing OLT were studied. Each patient received a pulmonary artery catheter and a 5F aortic catheter with an integrated thermistor. The thermistor of the aortic catheter were connected to one computer system (COLD-Z201, Pulsion Medical Systems, Munich, Germany). Haemodynamic data were registered an all the phases of OLT. PDR was measured during surgery in 12 patients. Correlations between PDR and the other markers of graft function (transaminases, protrombine time, and bile production) were sought. The correlation coefficient between CO TDa (COLD) and CO TDpa was r = 0.766 (p < 0.001), and an additional analysis according to Bland-Altman was also performed. There was a better correlation between the cardiac index (determined by two monitoring systems) and the volume measurements than the correlation observed with pressure preload parameters. The best correlations were found between the cardiac index in the femoral artery and intrathoracic blood volume index (ITBVI) and pulmonary blood volume index (PBVI) (r = 0.79 and r = 0.72, respectively; p < 0.01). PDR measured in the group patients with bad early graft function were lower (13.6 +/- 2.7) than those in the group with a good graft function (21.6 +/- 9) (p < 0.05). The degree of discrepancy between femoral and pulmonary thermodilution cardiac output measures is very wide during OLT so as to make the techniques using the COLD machine clinically useless. On the other hand, the volumes measured by COLD, specially ITBVI and PBVI, are more useful to asses the pre-load than pressure measurements. In OLT, the PDR measured within the first few hours after liver reperfusion may become a useful tool for early diagnosis of primary graft dysfunction (PDF).

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Indocyanine Green: Evaluation of Liver Function — Application in Intensive Care Medicine

Cited by 15 publications

References 16 publications

Perioperative monitoring of indocyanine green clearance and plasma disappearance rate in patients undergoing liver transplantation

Perioperative monitoring of indocyanine green clearance and plasma disappearance rate in patients undergoing liver transplantation

Indocyanine Green Plasma Disappearance Rate During the Anhepatic Phase of Orthotopic Liver Transplantation

Haemodynamic monitoring and liver function evaluation by pulsion cold system Z‐201 (PCS) during orthotopic liver transplantation

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