Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Anaesthesia. 2014 Dec;69(12):1364-76. doi: 10.1111/anae.12755. Epub 2014 Jun 4.
The dye indocyanine green is familiar to anaesthetists, and has been studied for more than half a century for cardiovascular and hepatic function monitoring. It is still, however, not yet in routine clinical use in anaesthesia and critical care, at least in Europe. This review is intended to provide a critical analysis of the available evidence concerning the indications for clinical measurement of indocyanine green elimination as a diagnostic and prognostic tool in two areas: its role in peri-operative liver function monitoring during major hepatic resection and liver transplantation; and its role in critically ill patients on the intensive care unit, where it is used for prediction of mortality, and for assessment of the severity of acute liver failure or that of intra-abdominal hypertension. Although numerous studies have demonstrated that indocyanine green elimination measurements in these patient populations can provide diagnostic or prognostic information to the clinician, 'hard' evidence - i.e. high-quality prospective randomised controlled trials - is lacking, and therefore it is not yet time to give a green light for use of indocyanine green in routine clinical practice.
染料吲哚菁绿对麻醉师来说并不陌生，它已经被研究了半个多世纪，用于心血管和肝功能监测。然而，它在麻醉和重症监护中尚未常规应用，至少在欧洲是这样。这篇综述旨在对现有的证据进行批判性分析，这些证据涉及吲哚菁绿消除的临床测量在两个领域的适应证：作为诊断和预后工具，用于重大肝切除和肝移植期间围手术期肝功能监测；以及在重症监护病房的危重病患者中，用于预测死亡率，评估急性肝功能衰竭或腹腔内高压的严重程度。尽管许多研究表明，在这些患者人群中，吲哚菁绿消除测量可以为临床医生提供诊断或预后信息，但缺乏“确凿”的证据，即高质量的前瞻性随机对照试验，因此，现在还不是将吲哚菁绿常规应用于临床实践的时候。
