Blood Volume Measurement at the Bedside Using ICG Pulse Spectrophometry

Haruna, Masaki; Kumon, Keiji; Yahagi, Naoki; Watanabe, Yasuhiko; Ishida, Yoshio; Kobayashi, Naoki; Aoyagi, Takuo

doi:10.1097/00000542-199812000-00008

Cited by 100 publications

(91 citation statements)

References 15 publications

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“…The ICG dye dilution curve can be used to measure hemodynamic parameters [13,14] . The currently available noninvasive method for measuring systemic hemodynamic parameters is pulse dye densitometry (PDD).…”

Section: Real-time Assessment Of Systemic Hemodynamic Statementioning

confidence: 99%

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Hori

Ogura

Onishi

et al. 2016

WJH

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Advanced liver cirrhosis is usually accompanied by portal hypertension. Long-term portal hypertension results in various vascular alterations. The systemic hemodynamic state in patients with cirrhosis is termed a hyperdynamic state. This peculiar hemodynamic state is characterized by an expanded blood volume, high cardiac output, and low total peripheral resistance. Vascular alterations do not disappear even long after liver transplantation (LT), and recipients with cirrhosis exhibit a persistent systemic hyperdynamic state even after LT. Stability of optimal systemic hemodynamics is indispensable for adequate portal venous flow (PVF) and successful LT, and reliable parameters for optimal systemic hemodynamics and adequate PVF are required. Even a subtle disorder in systemic hemodynamics is precisely indicated by the balance between cardiac output and blood volume. The indocyanine green (ICG) kinetics reflect the patient's functional hepatocytes and effective PVF, and PVF is a major determinant of the ICG elimination Hori T et al . Peculiar hemodynamics in advanced cirrhosis constant (k ICG) in the well-preserved allograft. The k ICG value is useful to set the optimal PVF during living-donor LT and to evaluate adequate PVF after LT. Perioperative management has a large influence on the postoperative course and outcome; therefore, key points and unexpected pitfalls for intensive management are herein summarized. Transplant physicians should fully understand the peculiar systemic hemodynamic behavior in LT recipients with cirrhosis and recognize the critical importance of PVF after LT.

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Section: Real-time Assessment Of Systemic Hemodynamic Statementioning

confidence: 99%

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Hori

Ogura

Onishi

et al. 2016

WJH

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“…9,10 Propofol concentrations in whole blood were measured using high performance liquid chromatography as reported previously.…”

Section: Analytical Proceduresmentioning

confidence: 99%

Une perfusion de dopamine diminue la concentration de propofol pendant le bloc péridural sous anesthésie générale

Takizawa

Nishikawa

Sato

et al. 2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : It is common clinical practice to use dopamine to manage the reduction in blood pressure accompanying epidural blockade. As propofol is a high-clearance drug, propofol concentrations can be influenced by cardiac output (CO). The purpose of the present study was to investigate the effects of dopamine infusions on propofol concentrations administered by a target-controlled infusion system during epidural block under general anesthesia.

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“…This baseline level gradually decreases during the measurement as a result of the elimination of the remaining indocyanine green. Hence, the area under the indocyanine green concentration curve is underestimated but the resulting error is negligible, as previously reported [21]. The blood concentration of indocyanine green was determined with a pulse dye densitogram analyser (DDG-2001, A ⁄ K, Nihon-Kohden, Tokyo, Japan), which was connected to a clip device attached to the patient's left forefinger.…”

Section: Methodsmentioning

confidence: 59%

“…Haruna et al compared pulse dye densitometry using indocyanine green 10 mg with a 131 iodine-labelled human serum method for blood volume determination in healthy volunteers. They reported that in 30% of the cases, pulse dye densitometry measurement failed because of motion artifacts or low signal-to-noise ratio [21]. In the same study, pulse dye densitometry measurements failed in > 30% of patients after cardiac surgery because of motion distortion or insufficient pulse amplitude.…”

Section: Discussionmentioning

confidence: 86%

“…Performance was particularly poor in the ICU, where the signals were low or absent in > 50% of the patients. Conflicting reports have been published on the accuracy of pulse dye densitometry [7,9,[11][12][13][14]21]. Bühlmann et al [11] and Imai et al [12] reported a satisfactory agreement between pulse dye densitometry and thermodilution, but the results of the Bland-Altman analysis do not justify their conclusion.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac output measurement by pulse dye densitometry in cardiac surgery

Baulig¹,

Bernhard²,

Béttex³

et al. 2005

Anaesthesia

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SummaryThe aim of this study was to compare the accuracy of pulse dye densitometry with that of bolus thermodilution cardiac output measurement in patients before and after elective coronary artery bypass grafting. Twenty-eight patients were studied. Agreement between mean thermodilution and pulse dye densitometry cardiac output values was assessed by Bland-Altman analysis. [2.0-7.2] l.min )1 for pulse dye densitometry using indocyanine green 20 mg. Mean bias was + 0.566 l.min )1 , the limits of agreement were ± 2.51 l.min )1 and mean error was 60.9%. Postoperative cardiac output data were not analysed because pulse dye densitometry signals were low or absent in > 50% of the patients. We conclude that pulse dye densitometry using indocyanine green 5 mg or 20 mg is inaccurate in anaesthetised patients before coronary artery bypass surgery and cannot be used after surgery because of a high incidence of low pulse dye densitometry signal amplitudes. Pulse dye densitometry is based on the principle of indocyanine green dye dilution, whereby indocyanine green is injected through a central [7] or peripheral [8] venous line and the changes in dye concentration over time are detected by pulse spectrophotometry using a finger probe [7,9] or a nose probe [10,11]. Only a few investigators [7,[12][13][14] have compared pulse dye densitometry with standard methods of cardiac output determination, and the accuracy of pulse dye densitometry is therefore in dispute.Our primary aim was to validate pulse dye densitometry in patients before and after elective coronary artery bypass graft surgery (CABG). Our secondary aim was to investigate whether different concentrations of indocyanine green would affect the accuracy of pulse dye densitometry. The accuracy of cardiac output determination by pulmonary thermodilution has been assessed and confirmed at our institution [15]. MethodsWith the approval of the Local Research Ethics Committee and written, informed consent, 28 patients who were scheduled for elective CABG were enrolled in the study. Exclusion criteria comprised: allergy to iodine, presence of an aortic counterpulsation device, severe renal disease or liver dysfunction and intake of drugs with a Anaesthesia, 2005, 60, pages 968-973

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Blood Volume Measurement at the Bedside Using ICG Pulse Spectrophometry

Cited by 100 publications

References 15 publications

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

Une perfusion de dopamine diminue la concentration de propofol pendant le bloc péridural sous anesthésie générale

Cardiac output measurement by pulse dye densitometry in cardiac surgery

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