Peri-operative plasma disappearance rate of indocyanine green after coronary artery bypass surgery. 2007

Michael Sander, and Claudia D Spies, and Achim Foer, and Doh-Yung Syn, and Herko Grubitzsch, and Christian Von Heymann
Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany.

Splanchnic ischaemia and hepatic dysfunction are severe complications after coronary artery bypass grafting (CABG) and lead to increased morbidity and mortality. Non-invasive determination of the indocyanine green (ICG) plasma disappearance rate (PDR) offers an opportunity for the early diagnosis of hepato-splanchnic hypoperfusion. The aim of this study was to establish the postoperative time course of the ICG PDR in elective uncomplicated CABG surgery. After ethical approval and written informed consent, the data of 40 patients were analysed during this prospective study. Measurements of the ICG PDR and cardiac index (CI) in 40 patients undergoing elective CABG surgery were performed immediately after induction of anaesthesia, on admission to the ICU, six hours after admission to the ICU, and on the first postoperative day. Prior to surgery, baseline ICG PDR was 17.7 %/min (13.6-20.4) and baseline CI was 2.2 l/min/m(2) (1.9-2.4). All measurements after surgery showed a significantly higher PDR and cardiac index compared to the baseline measurements. The only patient with prolonged ICU treatment failed to show this increase in ICG PDR, although the CI did increase after surgery. We established normal values of ICG PDR after uncomplicated CABG surgery. The elevated ICG PDR observed in our patients was assumed to be an effect of an increased hepato-splanchnic blood flow due to an increase in the CI. Patients at risk of hepato-splanchnic hypoperfusion, displaying a missed increase or even a decrease in their ICG PDR after surgery might be at risk of hepatic hypoperfusion and in these selected patients the ICG PDR could serve as a tool to guide therapy or to select patients who might benefit from more invasive devices to monitor hepatosplanchnic perfusion and function.

UI MeSH Term Description Entries
D007208 Indocyanine Green A tricarbocyanine dye that is used diagnostically in liver function tests and to determine blood volume and cardiac output. Cardio-Green,Cardiogreen,Ujoveridin,Vofaverdin,Vophaverdin,Wofaverdin,Cardio Green,Green, Indocyanine
D008102 Liver Circulation The circulation of BLOOD through the LIVER. Hepatic Circulation,Circulation, Liver,Circulation, Hepatic
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D004396 Coloring Agents Chemicals and substances that impart color including soluble dyes and insoluble pigments. They are used in INKS; PAINTS; and as INDICATORS AND REAGENTS. Coloring Agent,Dye,Dyes,Organic Pigment,Stain,Stains,Tissue Stain,Tissue Stains,Organic Pigments,Pigments, Inorganic,Agent, Coloring,Inorganic Pigments,Pigment, Organic,Pigments, Organic,Stain, Tissue,Stains, Tissue
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D013152 Splanchnic Circulation The circulation of blood through the BLOOD VESSELS supplying the abdominal VISCERA. Mesenteric Circulation,Circulation, Mesenteric,Circulation, Splanchnic,Circulations, Mesenteric,Circulations, Splanchnic,Mesenteric Circulations,Splanchnic Circulations
D017558 Elective Surgical Procedures Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery. Surgical Procedures, Elective,Elective Surgical Procedure,Procedure, Elective Surgical,Procedures, Elective Surgical,Surgical Procedure, Elective

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