Liver blood flow measured by indocyanine green in conscious unrestrained miniature pigs

1987 ◽  
Vol 187 (1) ◽  
pp. 71-79 ◽  
Author(s):  
U. Paschen ◽  
M. J. Müller
1989 ◽  
Vol 76 (5) ◽  
pp. 503-508 ◽  
Author(s):  
E. Burns ◽  
C. E. Ball ◽  
J. P. Christie ◽  
G. D. Broadhead ◽  
G. T. Tucker ◽  
...  

1. In order to estimate liver blood flow in the rat, the extraction ratio of Indocyanine Green was determined using a two-compartment model fitted to the plasma concentration time data after a single intravenous bolus dose and compared with values obtained directly by transhepatic sampling, both in the intact rat and in an isolated perfused rat liver preparation. 2. There was no agreement between estimates of the extraction ratio obtained by using the kinetic model and the directly measured values. 3. Elimination curves for Indocyanine Green were simulated to yield varied clearance values. Despite a 250% variation in clearance, extraction ratios derived using the two-compartment model were all greater than 0.9 and varied by less than 6%. 4. Estimates of liver blood flow obtained by deriving a value of the extraction ratio of Indocyanine Green using the two-compartment model are inaccurate.


1994 ◽  
Vol 86 (5) ◽  
pp. 497-503 ◽  
Author(s):  
J. Burggraaf ◽  
H. C. Schoemaker ◽  
J. M. Kroon ◽  
L. Huisman ◽  
C. Kluft ◽  
...  

1. Endogenous fibrinolytic capacity increases after administration of 1-desamino-8-d-vasopressin. This increase is commonly attributed to an increase in release of tissue-type plasminogen activator from the endothelium. However, the possibility that 1-desamino-8-d-vasopressin influences liver blood flow, which is a major determinant of tissue-type plasminogen activator clearance, cannot be ruled out. 2. The influence of 1-desamino-8-d-vasopressin on haemodynamics, liver blood flow and fibrinolytic parameters was investigated in a randomized double-blind cross-over study in nine healthy male subjects (age 20–26 years). 3. 1-Desamino-8-d-vasopressin exerted significant haemodynamic effects: mean arterial pressure decreased maximally 12 (95% confidence interval 8–15) mmHg and heart rate increased maximally 21 (95% confidence interval 15–27) beats/min. 4. Endogenous fibrinolytic parameters increased after administration of 1-desamino-8-d-vasopressin. Both tissue-type plasminogen activator antigen and tissue-type plasminogen activator activity were elevated and showed the maximal response shortly after drug administration was completed. 5. 1-Desamino-8-d-vasopressin increased portal venous blood flow as measured with echo-Doppler. The maximal increase in mean blood flow of 55 (95% confidence interval 19–92)% was observed at the end of the 1-desamino-8-d-vasopressin infusion and coincided with the maximal changes in systemic haemodynamics and fibrinolytic parameters. The increase in portal blood flow was not reflected in significant changes in Indocyanine Green clearance. It appears that the Indocyanine Green method is relatively insensitive to increases in liver blood flow. 6. The observed increase in fibrinolytic activity due to tissue-type plasminogen activator activity after 1-desamino-8-d-vasopressin administration may be due to an increased release of tissue-type plasminogen activator from the endothelium and is not caused by changes in clearance.


Perfusion ◽  
1999 ◽  
Vol 14 (1) ◽  
pp. 29-36 ◽  
Author(s):  
D AC Sharpe ◽  
I M Mitchel ◽  
E A Kay ◽  
J P McGoldrick ◽  
C M Munsch ◽  
...  

Liver blood flow is reduced after cardiopulmonary bypass (CPB) and both dopamine and dopexamine are used to overcome this. This study compares the effects of these agents on liver blood flow. Thirty patients undergoing elective coronary artery bypass graft surgery were randomized into three groups ( n = 10 per group). Six hours after surgery baseline liver blood flow was determined by the percentage disappearance rate of indocyanine green measured by dichromatic auricular densitometery. Patients then received infusions of either: (1) placebo (dextrose 5%); (2) dopamine (4 μg/kg/min); (3) dopexamine (1 μg/kg/min increasing to 2 μg/kg/min). One hour after infusion, liver blood flow measurements were repeated. In the dopexamine group the infusion was increased and the measurements repeated another hour later. We found that patient-specific variables and operative details were similar for all groups. Postoperative cardiac index and heart rate were increased significantly by dopamine (cardiac index 2.82 ± 0.46 l/m/m2 vs 3.28 ± 0.67 l/m/m2: p < 0.001 and heart rate 87.5 ± 13.2 vs 96 ± 16: p < 0.05) and dopexamine at 2 μg/kg/min (cardiac index 2.71 ± 0.53 l/m/m2 vs 3.45 ± 0.67 l/m/m2: p < 0.05 and heart rate 89.0 ± 18.9 vs 107.4 ± 13.6: p < 0.001) compared to placebo (cardiac index 2.97 ± 0.8 l/m/m2 vs 3.18 ± 0.9 l/m/m2: p > 0.05 and heart rate 77.2 ± 7.4 vs 77.3 ± 8: p > 0.05) despite similar atrial and systemic arterial pressures. The disappearance rate of indocyanine green was not altered during infusion of placebo group (9.0 ± 3.2%/min vs 7.9 ± 3.0%/min: p > 0.05) or dopexamine at 1 μg/kg/min (9.7 ± 3.1%/min vs 11.2 ± 4.1%/min: p > 0.05). The disappearance rate was increased with dopamine (6.7 ± 3.7%/min vs 11.8 ± 3.0%/min: p < 0.05) and dopexamine 2 μg/kg/min (9.7 ± 3.1%/min vs 13.5 ± 3.2%/min: p < 0.05). This indicates a 76% increase in liver blood flow with dopamine and a 38% increase with dopexamine. We conclude that dopamine 4 μg/kg/min and dopexamine 2 μg/kg/min increase liver blood flow, although this may, in part, be related to an increase in cardiac output. Dopexamine shows no advantage over dopamine in enhancing liver blood flow after CPB.


1997 ◽  
Vol 78 (03) ◽  
pp. 1015-1020 ◽  
Author(s):  
Jean M T van Griensven ◽  
Rudolph W Koster ◽  
Gwynn R Hopkins ◽  
Horst Beier ◽  
Wolfgang A Günzler ◽  
...  

SummaryBackground: The recombinant unglycosylated single chain urokinase-type plasminogen activator saruplase is cleared for a large part by the liver. A large interindividual variation in saruplase concentration is found in acute myocardial infarction (AMI) patients. The variable cardiac performance after an infarct may induce differences in liver blood flow that could explain the concentration diversity. This study was performed to investigate the relation between hepatic blood flow and the pharmacokinetic and pharmacodynamic properties of saruplase.Methods and Results: Thirteen AMI patients were enroled in this open label study. Patients received a bolus injection of 20 mg saruplase followed by a one-hour infusion of 60 mg saruplase. Concurrently 36 mg intravenous indocyanine green (ICG) was given over 1 h to measure hepatic blood flow. Blood samples were taken at regular time intervals to measure plasma levels of urokinase-type plasminogen activator (u-PA) antigen and activity, the two-chain form (tcu-PA) activity, indocyanine green, fibrinogen, fibrin and fibrin degradation products, α2-antiplasmin and thrombin antithrombin III complex. A correlation was seen between the clearance of ICG and both those of u-PA antigen (r = 0.62; p <0.05) and u-PA activity (r = 0.57; p <0.05). A negative correlation was seen between the area under the curve of tcu-PA activity and the areas under the effect curves of both fibrinogen and α2-antiplas-min (r = -0.84; p <0.01 and r = -0.65; p <0.05).Conclusions: Liver blood flow is an important determinant of the clearance of u-PA antigen and activity and reduction of flow in patients with heart failure will lead to an increase in plasma concentrations. High plasma concentrations of tcu-PA activity lead to increased systemic fibrinogenolysis. These results may be used to optimize saruplase treatment in patients with impaired cardiac function or after co-medication with drugs that affect liver blood flow.


1960 ◽  
Vol 199 (3) ◽  
pp. 481-484 ◽  
Author(s):  
Sigmund G. Ketterer ◽  
Bernard D. Wiegand ◽  
Elliot Rapaport

Indocyanine green when injected intravenously into normal dogs rapidly disappears, after mixing, from the circulation in an initial exponential fashion. This property enables one to calculate its original volume of distribution and its clearance from the circulation. The initial volume of distribution corresponded closely with the circulating plasma volume. Recovery of the dye from surgically created biliary fistulas approached 100% of the injected amounts and averaged 91%. During constant infusion, significant hepatic arteriovenous differences in dye concentrations occurred, making it possible to calculate hepatic clearances, extraction ratios and liver blood flow. The values obtained by the latter method agreed well with those obtained following single injections. The virtually complete hepatic uptake of Indocyanine green, ease of quantitative plasma and biliary determinations and its exponential loss from the circulation with a short half-life provide advantages over previously used substances in evaluating hepatic function and blood flow.


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