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A modified method of measuring plasma volume with indocyanine green: reducing the frequency of blood sampling while maintaining accuracy

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Abstract

Among various methods for measuring the plasma volume (PV), the indocyanine green (ICG) dilution technique is a relatively less invasive method. However, the ICG method is rather cumbersome because 10 blood samples need to be obtained within a short time after ICG administration. Thus, reducing the frequency of blood sampling while maintaining the accuracy would facilitate plasma volume measurement in clinical situations. We here developed a modified method to measure plasma volume using 2260 ICG plasma concentration data from 115 surgical patients. The mean relative error (MRE) and the percentage of cases with relative error (RE) greater than 5% in total (PRE) were used to quantify the difference between plasma volumes obtained by the original and modified methods. RE was determined as follows. RE(%) = (PV obtained by original method (PVoriginal)—PV obtained by modified method (PVmodified))/PVoriginal × 100. PVmodified was assumed to be equal to PVoriginal when the RE was < 5%. When the number of samples selected for the plasma volume estimation was 4 or less, the PRE was mostly 10% or more. Five out of the 10 blood samples (order: 1st, 2nd, 3rd, 9th, and 10th) showed similar accuracies with the plasma volume obtained by the original method (original: 2.72 ± 0.64 l, modified: 2.72 ± 0.65 l). This modified method may be able to aptly replace the original method and lead to a wider clinical application of the ICG dilution technique. Further validation is needed to determine if the results of this study may be applied in other populations.

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Acknowledgements

We thank Dr Joon Seo Lim from the Scientific Publications Team at Asan Medical Center for his editorial assistance in preparing this manuscript.

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Author notes

  1. Byung-Moon Choi and Eun-Kyung Lee contributed equally to this work as corresponding authors.

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Kyung Mi Kim, Do-Yang Park, Myojung Kim & Byung-Moon Choi

  2. Department of Statistics, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Korea

    Eun-Hwa Kang & Eun-Kyung Lee

  3. Departments of Anaesthesiology and Pain Medicine, Clinical Pharmacology and Therapeutics, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea

    Gyu-Jeong Noh

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  1. Kyung Mi Kim
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Kim, K.M., Park, DY., Kang, EH. et al. A modified method of measuring plasma volume with indocyanine green: reducing the frequency of blood sampling while maintaining accuracy. J Clin Monit Comput 35, 779–785 (2021). https://doi.org/10.1007/s10877-020-00536-5

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  • DOI: https://doi.org/10.1007/s10877-020-00536-5

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