Menth-Meier S E, Imoberdorf R, Regli B, Kipfer B, Turgay M, Ballmer P E
Department of Internal Medicine, Kantonsspital Winterthur, Switzerland.
Intensive Care Med. 2001 May;27(5):925-9. doi: 10.1007/s001340100942.
Validation of plasma volume (PV) determination by indocyanine green (ICG) in comparison to the gold-standard method with radioiodinated albumin, and investigation of the effect of commonly used plasma expanders (albumin, hydroxyethyl starch, and polygelatine) on PV in the early postoperative phase in patients undergoing cardiac surgery.
Prospective clinical study.
Department of medicine and intensive care unit at a university hospital.
Ten healthy volunteers and 21 patients after elective open-heart surgery.
PV of subjects was measured by i.v. injecting 5 microCi [125I]albumin (I-ALB). One hour later, PV was determined by a peripheral i. v. injection of 0.25 mg/kg body weight ICG (ICG1). In five subjects PV was measured repeatedly by ICG (ICG2) 1 h after ICG1. Mean PV of I-ALB and ICG1 or ICG2 showed consistent results. Further, we investigated central vs peripheral intravenous injection of ICG in six patients after open-heart surgery compared to [125I]albumin. There was no difference between mean PV measured by [125I]albumin and peripheral ICG (P = 0.40). PV determined by central injection of ICG was significantly higher than by the other methods. In 15 patients PV was determined by [125I]albumin. Thereafter, patients were randomly divided into three groups. Group ALB was infused with 1.75 ml/kg body weight human albumin 20%, group HAES with 5.25 ml/kg body weight hydroxyethyl starch 6%, and group HAEM with 7.0 ml/kg body weight polygelatine 3.5%. PV was measured 1 h and 4 h after infusion by ICG. There were no significant changes in PV between the groups.
PV determination by peripheral i. v. injection of ICG produced reliable and consistent results when a reactive hyperaemia was produced by a tourniquet prior to injection. Therefore, central venous injection of ICG may not be prerequisite for precise measurements of PV. The expected acute increase in PV after infusion of commonly used plasma expanders after cardiac surgery was not found.
与放射性碘标记白蛋白的金标准方法相比，验证通过吲哚菁绿（ICG）测定血浆容量（PV），并研究常用血浆扩容剂（白蛋白、羟乙基淀粉和聚明胶肽）对心脏手术患者术后早期PV的影响。
前瞻性临床研究。
大学医院的内科和重症监护病房。
10名健康志愿者和21名择期心脏直视手术后的患者。
通过静脉注射5微居里[125I]白蛋白（I-ALB）测量受试者的PV。1小时后，通过外周静脉注射0.25mg/kg体重的ICG（ICG1）测定PV。在五名受试者中，在ICG1后1小时通过ICG（ICG2）重复测量PV。I-ALB和ICG1或ICG2的平均PV显示出一致的结果。此外，我们比较了心脏直视手术后六名患者中ICG的中心静脉注射与外周静脉注射与[125I]白蛋白的情况。[125I]白蛋白和外周ICG测量的平均PV之间没有差异（P = 0.40）。通过中心注射ICG测定的PV显著高于其他方法。在15名患者中通过[125I]白蛋白测定PV。此后，患者被随机分为三组。ALB组输注1.75ml/kg体重的20%人白蛋白，HAES组输注5.25ml/kg体重的6%羟乙基淀粉，HAEM组输注7.0ml/kg体重的3.5%聚明胶肽。输注后1小时和4小时通过ICG测量PV。各组之间PV没有显著变化。
当在注射前通过止血带产生反应性充血时，通过外周静脉注射ICG测定PV可产生可靠且一致的结果。因此，中心静脉注射ICG可能不是精确测量PV的先决条件。未发现心脏手术后输注常用血浆扩容剂后PV预期的急性增加。
