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Its Use as an Early Indicator of Hepatic Dysfunction Following Injury in Man

Marc E. Gottlieb, MD; Howard H. Stratton, PhD; Jonathan C. Newell, PhD; Dhiraj M. Shah, MD

Arch Surg. 1984;119(3):264-268.

Abstract
• To evaluate hepatic function, the kinetics of indocyanine green clearance were studied in seven injured patients with hepatic venous catheters. Indocyanine green clearance after a bolus injection of 20 mg was relatively monoexponential on the first day after injury. Following this, a second slower compartment of indocyanine green clearance was uniformly evident, becoming most prominent around the fourth day after injury. Indocyanine green clearance again became more uniform as recovery continued. Fractional indocyanine green extraction ten minutes after injection decreased from 0.9 on the first day after injury to 0.2 three days later, and then returned to 0.7 on the seventh day after injury. These decreases in indocyanine green clearance preceded an increase in total serum bilirubin concentration to a mean value of 1.9 mg/dL. Indocyanine green clearance was thus found to be an early and sensitive indicator of impaired hepatic function.

(Arch Surg 1984;119:264-268)

Author Affiliations
From the Department of Surgery (Drs Gottlieb and Shah), Albany (NY) Medical College of Union University; State University of New York at Albany (Dr Stratton); and the Center for Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY (Dr Newell).

Footnotes
Accepted for publication Sept 28, 1983.

Reprint requests to Department of Surgery, Albany Medical College, Albany, NY 12208 (Dr Shah).

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