Does indocyanine green accurately measure plasma volume early after cardiac surgery?
Does indocyanine green accurately measure plasma volume early after cardiac surgery?
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DOI：
10.1097/00000539-200204000-00003
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发表时间：
2002-04-01
影响因子：
5.7
通讯作者：
Matsuki, A
中科院分区：
文献类型：
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作者：
Ishihara, H;Okawa, H;Matsuki, A
传统的吲哚青绿(ICG)稀释法(PV-ICG)测定血浆容量(PV)时，由于ICG与蛋白质结合，当存在普遍的毛细血管蛋白渗漏时，可能会高估血浆容量(PV)。我们最近报道，这种高估可以通过同时测量葡萄糖的初始分布体积(IDVG)来识别。我们以PV-ICG/IDVG比值为指标，研究了高估PV-ICG和进一步的ICG-脉冲染料密度法衍生的血浆体积(PV-PDD)是否会在心脏手术后早期发生。可能的高估被定义为高于0.45的比率。连续24例心脏手术后患者入选。在入住重症监护病房后和术后第一天同时计算PV-ICG、PV-PDD和IDVG。47个记录的平均+/-SD PV-ICG/IDVG比值为0.38+/-0.05。4例PV-ICG/IDVG>0.45，最高为0.48。总共47个记录的平均PV-PDD/IDVG比率为0.39+/-0.10。在PV-PDD测定中观察到极高或极低的比率，但在PV-ICG测定中未观察到这些比率。结果表明，大多数PV-ICG测量是准确的，但PV-PDD的不准确可能发生在心脏手术后的早期。
Potential overestimation of plasma volume (PV) determination by the conventional indocyanine green (ICG) dilution method (PV-ICG) can occur when generalized capillary protein leakage is present, because ICG binds to proteins. We recently reported that this overestimation can be recognized by simultaneous measurement of the initial distribution volume of glucose (IDVG). We examined whether overestimation of PV-ICG and further ICG-pulse dye densitometry-derived plasma volume (PV-PDD) can occur early after cardiac surgery by using the PV-ICG/IDVG ratio as an indica tor. Possible overestimation was defined as a ratio higher than 0.45. Twenty-four consecutive postcardiac surgical patients were enrolled. PV-ICG, PV-PDD, and IDVG were calculated simultaneously after admission to the intensive care unit and on the first postoperative day. The mean +/- SD PV-ICG/IDVG ratio for 47 recordings was 0.38 +/- 0.05. Four had a PV-ICG/IDVG ratio higher than 0.45, and the highest was 0.48. The mean PV-PDD/IDVG ratio for a total of 47 recordings was 0.39 +/- 0.10. There were extremely high or low ratios observed in PV-PDD determinations, but they were not observed in PV-ICG determinations. Results suggest that most of the PV-ICG measurements are accurate, but inaccuracy of PV-PDD can occur early after cardiac surgery.