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Assessment of liver perfusion and function by indocyanine green in the perioperative setting and in critically ill patients

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Abstract

Indocyanine green (ICG) is a water-soluble dye that is bound to plasma proteins when administered intravenously and nearly completely eliminated from the blood by the liver. ICG elimination depends on hepatic blood flow, hepatocellular function and biliary excretion. ICG elimination is considered as a useful dynamic test describing liver function and perfusion in the perioperative setting, i.e., in liver surgery and transplantation, as well as in critically ill patients. ICG plasma disappearance rate (ICG-PDR) which can be measured today by transcutaneous systems at the bedside is a valuable method for dynamic assessment of liver function and perfusion, and is regarded as a valuable prognostic tool in predicting survival of critically ill patients, presenting with sepsis, ARDS or acute liver failure.

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Fig. 1
Fig. 2

Modified from Imamura et al. [45]

Fig. 3

Modified from Seibel et al. [73]

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Abbreviations

ICG:

Indocyanine green

PDR:

Plasma disappearance rate

R15:

Retention rate after 15 min

MELD:

Model of End-stage Liver Disease

Cl:

Clearance

CT:

Computed tomography

MEGX:

Monoethylglycinexylidide

APACHE:

Acute Physiology and Chronic Health Evaluation

SAPS:

Simplified Acute Physiology Score

IAP:

Intraabdominal pressure

PDD:

Pulse dye densitometry

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Sakka, S.G. Assessment of liver perfusion and function by indocyanine green in the perioperative setting and in critically ill patients. J Clin Monit Comput 32, 787–796 (2018). https://doi.org/10.1007/s10877-017-0073-4

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