Ishihara H, Otomo N, Suzuki A, Takamura K, Tsubo T, Matsuki A
Department of Anesthesiology, University of Hirosaki School of Medicine, Japan.
Burns. 1998 Sep;24(6):525-31. doi: 10.1016/s0305-4179(98)80004-1.
Overestimation of the plasma volume determined by the indocyanine green (ICG) dilution method (PV-ICG) may occur after burns, since this dye has the potential of extravasation in the presence of the capillary protein leakage. Assuming that the initial distribution volume of glucose (IDVG) consistently indicates the extracellular fluid volume of highly perfused organs including plasma, overestimation of the PV-ICG can be detected by a higher PV-ICG/IDVG ratio. The present study was designed to test whether a higher PV-ICG/IDVG ratio is observed within 24 h post-burn compared to the subsequent days. Ten severely burned adult patients admitted to the ICU were studied through the 2nd post-burn day. The daily IDVG and PV-ICG were calculated using a one compartment model by simultaneous administration of glucose, 5 g, and ICG, 25 mg. Although the IDVG increased on the 1st post-burn day (p < 0.05), the PV-ICG remained unchanged. The PV-ICG/IDVG ratio within 24 h post-burn was significantly higher than that on the 1st post-burn day (p < 0.01). Results indicate that overestimation of the PV-ICG can occur within 24 h post-burn and suggest that simultaneous measurement of the IDVG and the PV-ICG would help predict the generalized capillary protein leakage after burns.
由于在存在毛细血管蛋白渗漏的情况下，吲哚菁绿（ICG）有外渗的可能性，因此烧伤后可能会出现通过ICG稀释法（PV-ICG）测定的血浆容量被高估的情况。假设葡萄糖的初始分布容积（IDVG）始终表明包括血浆在内的高灌注器官的细胞外液容积，那么通过较高的PV-ICG/IDVG比值就可以检测到PV-ICG的高估。本研究旨在测试与随后几天相比，烧伤后24小时内是否会观察到较高的PV-ICG/IDVG比值。对入住重症监护病房的10名成年重度烧伤患者进行了直至烧伤后第2天的研究。通过同时给予5g葡萄糖和25mg ICG，使用单室模型计算每日的IDVG和PV-ICG。虽然烧伤后第1天IDVG增加（p<0.05），但PV-ICG保持不变。烧伤后24小时内的PV-ICG/IDVG比值显著高于烧伤后第1天（p<0.01）。结果表明，烧伤后24小时内可能会出现PV-ICG的高估，这表明同时测量IDVG和PV-ICG将有助于预测烧伤后的全身性毛细血管蛋白渗漏。
