Intensive Care Medicine

, Volume 30, Issue 3, pp 506–509

Measurement of indocyanine green plasma disappearance rate by two different dosages

  • Samir G. Sakka
  • Heiko Koeck
  • Andreas Meier-Hellmann
Brief Report



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).


Clinical study.


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.


Organ function Indocyanine green Plasma disappearance rate Critically ill patients 


  1. 1.
    Sakka SG, Reinhart K, Meier-Hellmann A (2002) Prognostic value of the indocyanine green plasma disappearance rate in critically ill patients. Chest 122:1715–1720CrossRefPubMedGoogle Scholar
  2. 2.
    Kholoussy AM, Pollack D, Matsumoto T (1984) Prognostic significance of indocyanine green clearance in critically ill surgical patients. Crit Care Med 12:115–116PubMedGoogle Scholar
  3. 3.
    Sakka SG, Reinhart K, Meier-Hellmann A (2001) Comparison of invasive and noninvasive measurements of indocyanine green plasma disappearance rate in critically ill patients with mechanical ventilation and stable hemodynamics. Intensive Care Med 26:1553–1556CrossRefGoogle Scholar
  4. 4.
    Krenn CG, Schäfer B, Berlakovich GA, Steininger R, Steltzer H, Spiss CK (1998) Detection of graft non-function after liver transplantation by assessment of indocyanine green kinetics. Anesth Analg 87:34–36PubMedGoogle Scholar
  5. 5.
    Kimura S, Yoshioka T, Shibuya M, Sakano T, Tanaka R, Matsuyama S (2001) Indocyanine green elimination rate detects hepatocellular dysfunction early in septic shock and correlates with survival. Crit Care Med 29:1159–1163PubMedGoogle Scholar
  6. 6.
    Hashimoto M, Watanabe G (2000) Hepatic parenchymal cell volume and the indocyanine green tolerance test. J Surg Res 92:222–227CrossRefPubMedGoogle Scholar
  7. 7.
    Lehmann C, Taymoorian K, Wauer H, Krausch D, Birnbaum J, Kox WJ (2000) Effects of the stable prostacyclin analogue iloprost on the plasma disappearance rate of indocyanine green in human septic shock. Intensive Care Med 26:1557–1560PubMedGoogle Scholar
  8. 8.
    Orii R, Sugawara Y, Hayashida M, Yamada Y, Chang K, Takayama T, Makunchi M, Manaoka K (2000) Effects of amrinone on ischaemia-reperfusion injury in cirrhotic patients undergoing hepatectomy: a comparative study with prostaglandin E1. Br J Anaesth 85:389–395PubMedGoogle Scholar
  9. 9.
    Devlin J, Ellis AE, McPeake J, Heaton N, Wendon JA, Williams R (1997) N-acetylcysteine improves indocyanine green extraction and oxygen transport during hepatic dysfunction. Crit Care Med 25:236–242CrossRefPubMedGoogle Scholar
  10. 10.
    Sakka SG, Reinhart K, Wegscheider K, Meier-Hellmann A (2001) Variability of splanchnic blood flow in patients with sepsis. Intensive Care Med 27:1281–1287Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Samir G. Sakka
    • 1
  • Heiko Koeck
    • 1
  • Andreas Meier-Hellmann
    • 2
  1. 1.Department of Anesthesiology and Intensive Care MedicineFriedrich-Schiller-University of JenaJenaGermany
  2. 2.Department of Anesthesiology and Intensive Care MedicineHELIOS-KlinikumErfurtGermany

Personalised recommendations