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Plasma disappearance of indocyanine green: a marker for excretory liver function?

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Abstract

Objective

To investigate whether the plasma disappearance rate of indocyanine green (ICG) assessed using a commercially available bedside monitor provides an accurate estimation of cumulative biliary ICG excretion in a clinically relevant model of long-term, hyperdynamic porcine endotoxemia.

Design and setting

Prospective experimental study in the animal laboratory in a university hospital.

Subjects

Fifteen domestic pigs.

Interventions

Pigs were anesthetized, mechanically ventilated, and instrumented. Intravenous endotoxin was continuously infused over 12 h concomitant with fluid resuscitation. Measurements were performed before and 12 h after the start of endotoxin infusion.

Measurements and results

All animals developed hyperdynamic circulation characterized by a sustained increase in cardiac output. Despite well maintained portal venous and consequently total liver blood flow endotoxemia decreased hepatic lactate uptake, which was accompanied by a significant fall in portal and hepatic venous pH. Both the cumulative bile flow and biliary ICG and bicarbonate excretion measured during 1 h after intravenous bolus of 25 mg ICG fell significantly. By contrast, neither the plasma disappearance rate of ICG nor the rate corrected for liver blood flow exhibited any changes over time.

Conclusions

In hyperdynamic porcine endotoxemia the plasma disappearance rate of ICG failed to accurately substitute for direct short-term measures of biliary ICG excretion. Hence normal values of plasma disappearance rate of ICG should be interpreted with caution in early, acute inflammatory conditions.

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Authors and Affiliations

  1. Klinik und Poliklinik für Chirurgie, Universitätsklinikum, Regensburg, Germany

    Alexander Stehr & Carl Zuelke

  2. Regional Hospital Sterzing, Department of Anesthesiology and Intensive Care, Sterzing, Italy

    Franz Ploner

  3. JIP, 1. Interni Klinika, Lekarska Fakulta a Fakultni Nemocnice Plzen, Karlova Univerzita Praha, Alej svobody 80, 30460, Plzen, Czech Republic

    Martin Matejovic

  4. Sektion Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinikum, Ulm, Germany

    Karl Traeger, Peter Radermacher & Martin Matejovic

  5. Klinik und Poliklinik für Anästhesiologie und Operative Intensvimedizin, Westfälische Wilhelms-Universität, Münster, Germany

    Marc Theisen

Authors
  1. Alexander Stehr
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  2. Franz Ploner
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  3. Karl Traeger
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  4. Marc Theisen
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  5. Carl Zuelke
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  6. Peter Radermacher
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  7. Martin Matejovic
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Corresponding author

Correspondence to Martin Matejovic.

Additional information

A. Stehr and F. Ploner contributed equally to this study

This research was supported by Deutsche Forschungsgemeinschaft (Ra 396/3-1) and a research fellowship from the Alexander von Humboldt Stiftung (M.M.)

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Stehr, A., Ploner, F., Traeger, K. et al. Plasma disappearance of indocyanine green: a marker for excretory liver function?. Intensive Care Med 31, 1719–1722 (2005). https://doi.org/10.1007/s00134-005-2826-7

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  • DOI: https://doi.org/10.1007/s00134-005-2826-7

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