Abstract
Objective. Pulse dye-densitometry (PDD) is a newly developed methodfor monitoring the indocyanine green (ICG) concentration in an artery withwhich cardiac output (CO) and circulating blood volume (CBV) can bedetermined. We evaluated its accuracy for clinical use. Methods. In 7patients under general anesthesia, ICG-sensitive optical probes (805 and 890nm) were attached to a finger. Following injection of ICG, the arterialconcentration of dye was recorded optically by the non-invasive testinstrument and sampled arterial blood ICG concentration was also measuredphotometrically for comparison. In order to validate the PDD analysis, CO wasalso measured by both the dye dilution cuvette method and by thermodilutionin 8 patients scheduled for coronary artery bypass grafting. In 30 otherpatients, CBV assessed by PDD was compared with its value estimated from bodysize. Results. The blood dye concentration correlated well with thevalues obtained by PDD (r = 0.953, p < 0.01). Meanbias for the test PDD CO was +0.15 ± 0.72 minl−1 (not significant (n.s.)) compared with the cuvette methodwhile the mean bias of the thermodilution method vs thecuvette method was +0.79 ± 0.84 min l−1 (p < 0.0001.). The average value of CBV obtained by PDD was 3.81± 1.39 L compared with that estimated value, 3.72 ± 0.77 L (n.s.).Conclusions. CO determined by PDD agrees wellwith cuvette densitometry, and somewhat less well with CO by thermodilution.The new method, by not requiring a pulmonary arterial catheter, is lessinvasivethan either older method, and yields in addition a value of CBV.
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REFERENCES
Eidelman LA, Pizov R, Sprung CL. Pulmonary artery catheterization-At the crossroads? Crit Care Med 1994; 22(4): 543–545
Shoemaker WC. Use and abuse of the balloon tip pulmonary artery (Swan-Ganz) catheter: Are patients getting their money's worth. Crit Care Med 1990; 18(11): 1294–1296
Sibbald WJ, Sprung CL. The pulmonary artery catheter: The debate continues. Chest 1988; 94(5): 899–901
Aoyagi T. Theoretical and experimental study of optical attenuation of blood. (in Japanese with English abstract) Japanese Journal of Medical Electronics and Biological Engineering 1992; 30(1) 1–7
Ogawa R, Fujita T, Fukuda Y. Blood volume studies in healthy Japanese (in Japanese with English abstract). Kokyuu to Junkan (Respiration and Circulation) 1970; 18: 833–837
Bland JM, Altman DG. Statistical method for assessing agreement between two methods of clinical measurement. The Lancet 1986; Feb 8: 307–310
Severinghaus JW, Honda Y. History of blood gas analysis. VII Pulse oximetry. J Clin Monit 1987; 3: 135–138
Aoyagi T. Pulse oximetry: Its origin and development as pulse spectrophotometry. Abstracts, IEEE Annual Meeting, Paris, 1992
Eichhorn JH. Prevention of intraoperative anesthesia accidents and related severe injury through safety monitoring. Anesthesiology 1989; 70: 572–577
Grasberger RC, Yeston NS. Less-invasive cardiac output monitoring by earpiece densitometry. Crit Care Med 1986; 14(6): 577–579
Leevy CM, Medenhall CL, Lesko W, Howard MM Estimation of hepatic blood flow with indocyanine green. J Clin Invest 1962; 41: 1169–1175
Kobayashi M, Sugimachi K, Yao S, Saku M, Ogawa Y, Inokuchi K Our appraisal on surgical indication for patients with hepatic dysfunction. Jpn J Gastroenterol Surg 1974; 7(2): 50–56
Renner LE, Morton MJ, Sakuma GY. Indicator amount, temperature, and intrinsic cardiac output affect thermodilution cardiac output accuracy and reproducibility. Crit Care Med 1993; 21(4): 586–597
Kohanna FH, Cunningham JN. Monitoring of caridiac output by thermodilution after open-heart surgery. J Thorac Cardiovasc Surg 1977; 73: 451–457
van Grondelle A, Ditchey RV, Groves BM, Wagner WW, Reeves JT. Thermodilution method overestimates low cardiac output in humans. Am J Physiol 245 (Heart Circ Physiol 14) 1983, H690–692
Albert SN. Blood volume and extracellular fluid volume. 2nd ed. Springfield: Charles C Thomas Publishers, 1971
Thomsen JK, Fogh-Andersen N, Bü low K Devantier A. Blood and plasma volumes determined by carbon monoxide gas, 99mTc-labelled erythrocytes, 125I-albumin and the T1824 technique. Scand J Clin Lab Invest 1991; 51: 185–190
Scheltinga MR, Helton WS, Rounds J. Impedance electrodes positioned on proximal portions of limbs quantify fluid compartments in dogs. J Appl Physiol 1991; 70(5): 2039–2044
Snyder CL, Saltzman D, Happe J, Eggen MA, Ferrell KL, Leonard AS. Peripheral venous monitoring with acute blood volume alteration: Cuff-occluded rate of rise of peripheral venous pressure. Crit Care Med 1990; 18: 1142–1145
Schneditz D, Pogglitsch H, Horina J, Binswanger U. A blood protein monitor for the continuous measurement of blood volume changes during hemodialysis. Kidney Int 1990; 38: 342–346
de Vries JPPM, Olthof CG, Visser V, Kouw PM, van Es A, Donker AJM, de Vries PMJM.: Continuous measurement of blood volume during hemodialysis by an optical method. ASAIO J 1992; 38: M181–M185
Cordts PR, LaMorte WW, Fischer JB, DelGuercio C, Niehoff J, Pivacek LE, Dennis RC, Siebens H, Georgio A, Valeri CR, Menzoian JO.: Poor predictive value of hematocrit and hemodynamic parameters for erythrocyte deficits after extensive vascular operations. Surg Gynecol Obstet 1992; 175: 243–248
Hoeft A, Schorn B, Weyland A, Scholz M, Buhre W, Stepanek E, Allen SJ, Sonntag H. Bedside assessment of intravascular volume status in patients undergoing coronary bypass surgery. Anesthesiology 1994; 81: 76–86
Bradley EC, Barr JW.: Determination of blood volume using indocyanine green (Cardio-Green) dye. Life Sci 1968; 7 Part I, 1001–1007
Haneda K, Horiuchi T. A method for measurement of total circulating blood volume using indocyanine green. Tohoku J exp Med 1986; 148, 49–56
Haller M, Brechtelsbauer AH, Fett W, Briegel J, Finsterer U, Peter K. Determination of plasma volume with indocyanine green in man. Life Sci 1993; 53: 1597–1604
Kisch H, Leucht S, Lichtwarck-Aschoff M, et al. Accuracy and reproducibility of the measurement of actively circulating blood volume with an integrated fiberoptic monitoring system. Crit Care Med 1995; 23: 885–893
Schuster A. Radiation through a foggy atmosphere. Astrophys J. 1905; 21(1): 1–22
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Iijima, T., Aoyagi, T., Iwao, Y. et al. Cardiac output and circulating blood volume analysis by pulse dye-densitometry. J Clin Monit Comput 13, 81–89 (1997). https://doi.org/10.1023/A:1007339924083
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DOI: https://doi.org/10.1023/A:1007339924083