He Y L, Tanigami H, Ueyama H, Mashimo T, Yoshiya I
Department of Anesthesiology, Osaka University Medical School, Suita City, Japan.
Crit Care Med. 1998 Aug;26(8):1446-51. doi: 10.1097/00003246-199808000-00036.
To systematically investigate the reproducibility and reliability of a newly developed, less invasive approach of estimating blood volume (BV), using indocyanine green (ICG) measured with pulse-spectrophotometry.
Prospective, clinical study.
Surgical unit at a university hospital.
Twenty-two patients undergoing general anesthesia for elective surgery and seven healthy volunteers.
Catheters were inserted into the forearm veins of healthy volunteers for the administration of ICG and blood sampling for the measurement of hemoglobin concentration.
The distribution volumes of ICG in seven healthy volunteers were estimated repetitively following three or four consecutive intravenous administrations at 30-min intervals. A low intrasubject coefficient of variation of 3.94 +/- 2.03 (SEM) % and a reasonable intersubject coefficient of variation of 13.3 +/- 5.52% (in mL/kg) for the BV measurements were obtained. In addition, ICG was administered to 22 patients, first under general anesthesia by a bolus, and then by a bolus with a constant-rate infusion. The ICG blood concentration was noninvasively measured with pulse-spectrophotometry. The blood concentration time courses following both bolus and constant-rate infusion were well fitted by the one-compartment model, indicating that the distribution equilibrium of ICG is instantaneous. The distribution volumes estimated following bolus injection correlate closely with the distribution volume estimated based on constant-rate infusion administration (r2 = .90).
The BV estimation with a bolus injection of ICG and pulse-spectrophotometry is reliable, as reflected by the reproducible BVs estimated in the same subject. The integrated pulse-spectrophotometry monitoring system offers a less invasive and useful tool for bedside estimation of BV.
采用脉搏分光光度法测量吲哚菁绿（ICG），系统研究一种新开发的、侵入性较小的估计血容量（BV）方法的可重复性和可靠性。
前瞻性临床研究。
大学医院的外科病房。
22例行择期手术全身麻醉的患者和7名健康志愿者。
将导管插入健康志愿者的前臂静脉，用于注射ICG和采集血样以测量血红蛋白浓度。
在7名健康志愿者中，每隔30分钟连续静脉注射三或四次ICG后，重复估计ICG的分布容积。BV测量的受试者内变异系数较低，为3.94±2.03（SEM）%，受试者间变异系数合理，为13.3±5.52%（以mL/kg计）。此外，对22例患者先在全身麻醉下静脉推注ICG，然后再静脉推注并持续输注。用脉搏分光光度法无创测量ICG血药浓度。推注和持续输注后的血药浓度时间过程均能很好地用单室模型拟合，表明ICG的分布平衡是瞬时的。推注后估计的分布容积与基于持续输注给药估计的分布容积密切相关（r2 = 0.90）。
同一受试者估计的BV具有可重复性，这反映出静脉推注ICG和脉搏分光光度法估计BV是可靠的。集成脉搏分光光度法监测系统为床边BV估计提供了一种侵入性较小且有用的工具。
