Comparison of invasive and noninvasive measurement of plasma disappearance rate of indocyanine green in patients undergoing liver transplantation: A prospective investigator‐blinded study
Comparison of invasive and noninvasive measurement of plasma disappearance rate of indocyanine green in patients undergoing liver transplantation: A prospective investigator‐blinded study
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肝移植患者血浆吲哚菁绿消失率有创和无创测量的比较：一项前瞻性研究者双盲研究
作者：
P. Faybik;C. Krenn;A. Baker;D. Lahner;G. Berlakovich;H. Steltzer;H. Hetz
吲哚菁绿血浆消失率（PDRICG）已被提议用于评估肝移植供体和受体、慢性肝衰竭患者的肝功能，并作为危重患者的预后因素。在原位肝移植（OLT）患者中，使用一种新开发的无创数字脉冲密度测量方法评估PDRICG，同时将其与有创主动脉纤维法进行比较。连续14例肝移植候选者（11例男性，3例女性）被前瞻性纳入研究。所有患者通过股动脉鞘插入带有集成光纤装置和热敏电阻的4F主动脉导管，进行有创主动脉（INV） pdrig评估。光纤装置连接到计算机系统（COLD‐Z021，浦勒医疗系统，慕尼黑，德国）。手指片传感器用于无创（NINV）脉冲密度pdrig评估。PDRICG评估。通过中心静脉导管注射5 mg/kg的ICG冷却生理盐水（10 - 15 mL）。在麻醉诱导后、肝动脉夹持后、下腔静脉夹持后、移植物再灌注后、术后第一天进行PDRICG评估。在PDRICG测量期间，研究人员对无创监测结果进行盲法观察。成功地进行了71对测量。有创评估法的PDRICG范围为0%/min ~ 43.8% /min (11.6%/min±9.6% /min，平均±SD)，无创评估法的PDRICG范围为2.6%/min ~ 36.1% /min （10%/min±7.6% /min，平均±SD）。线性回归分析得到：PDRICGNINV = 1.493±0.735 × PDRICGINV，相关系数r = 0.93 （P < 0.0001）。根据Bland和Altman的分析，PDRICGNINV和PDRICGINV之间的一致性很好，所有测量值的平均偏差为1.5±3.8。总之，根据这些结果，无创经皮脉搏密度测量法与有创主动脉纤维法具有良好的相关性，因此可以用于肝移植患者。（《肝脏转译》2004；10:1060-1064。）
Plasma disappearance rate of indocyanine green (PDRICG) has been proposed for assessment of liver function in liver transplants donors and recipients, in patients with chronic liver failure, and as a prognostic factor in critically ill patients. The assessment of PDRICG using a newly developed noninvasive digital pulse densitometry method was simultaneously compared to invasive aortic fiber‐optic method in patients undergoing orthotopic liver transplantation (OLT). Fourteen consecutive liver transplant candidates (11 male, 3 female) were prospectively enrolled into the study. A 4F aortic catheter with an integrated fiber‐optic device and a thermistor was inserted via a femoral artery sheath for invasive aortic (INV) PDRICG assessment in all patients. The fiber‐optic device was connected to a computer system (COLD‐Z021, PULSION Medical Systems, Munich, Germany). A finger‐piece sensor was used for non‐invasive (NINV) pulse‐densitometric PDRICG assessment. For the PDRICG assessment .5 mg/kg of ICG in cooled saline (10‐15 mL) was injected through a central venous catheter. The assessments of PDRICG were performed after induction of anesthesia, after clamping of the hepatic artery, after clamping of the inferior vena cava, after reperfusion of the graft, and on the first postoperative day. During the PDRICG measurements, the investigators were blinded for the results of the noninvasive monitoring. Seventy‐one pairs of measurements were performed successfully. PDRICG ranged from 0%/min to 43.8 %/min (11.6%/min ± 9.6 %/min, mean ± SD) for invasive and from 2.6%/min to 36.1 %/min (10%/min ± 7.6 %/min, mean ± SD) for noninvasive assessment method. The linear regression analysis yielded the equation: PDRICGNINV = 1.493 ± 0.735 × PDRICGINV, with a correlation coefficient of r = 0.93 (P < .0001). The analysis according to Bland and Altman showed a good agreement between the PDRICGNINV and PDRICGINV with a mean bias 1.5 ± 3.8 for all measurements. In conclusion, according to these results, the noninvasive transcutaneous pulse‐densitometric method correlates well with the invasive aortic fiber‐optic method and thus can be used in patients undergoing liver transplantation. (Liver Transpl 2004;10:1060–1064.)