Measurement of indocyanine green plasma disappearance rate by two different dosages
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- Sakka, S.G., Koeck, H. & Meier-Hellmann, A. Intensive Care Med (2004) 30: 506. doi:10.1007/s00134-003-2091-6
While using a transcutaneous system for assessment of liver function by indocyanine green plasma disappearance rate (ICG-PDR) in critically ill patients, we compared the agreement between ICG-PDR obtained by the recommended standard ICG dosage (0.5 mg/kg) and a reduced dosage (0.25 mg/kg).
Intensive care unit of a university hospital.
Critically ill patients (n=16, 5 female, 11 male) who underwent liver function monitoring by ICG-PDR for clinical indication.
Measurements and results
We analyzed 31 pairs of ICG-PDR measurements by applying the recommended dosage (0.5 mg/kg, ICG-PDR0.5) and a reduced dosage (0.25 mg/kg, ICG-PDR0.25). For each comparative measurement either first 0.5 mg/kg or 0.25 mg/kg of ICG was injected in a random fashion and followed by the corresponding dosage 60 min later. All patients were sedated and mechanically ventilated via a tracheal tube. Each patient was monitored by an ICG finger clip which was connected to a liver function monitoring system (LiMon, Pulsion Medical Systems, Germany). ICG-PDR0.25 was 2.7–25.0 %/min and ICG-PDR0.5 4.5–24.5 %/min, respectively. Linear regression analysis revealed ICG-PDR0.25=1.13·ICG-PDR0.5−0.66 %/min (r=0.95, p<0.0001) with a mean bias 1.0 %/min (standard deviation 2.5 %/min). The 15 min residual rates were also highly correlated (r=0.92, p<0.0001) with a mean bias of 0.3%.
A reduced dosage of ICG (0.25 mg/kg) is sufficiently accurate for transcutaneous measurement of ICG-PDR in critically ill patients.