DETECTION OF CAPILLARY PROTEIN LEAKAGE BY GLUCOSE AND INDOCYANINE GREEN DILUTIONS DURING THE EARLY POSTBURN PERIOD

Overestimation of the plasma volume determined by the indocyanine gree n (ICG) dilution method (PV-ICG) may occur after burns, since this dye has the potential of extravasation in the presence of the capillary p rotein leakage. Assuming that the initial distribution volume of gluco se (IDVG) consistently indicates the extracellular fluid volume of hig hly perfused organs including plasma, overestimation of the PV-ICG can be detected by a higher PV-ICG/IDVG ratio. The present study was desi gned 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 d ay. The daily IDVG and PV-ICG were calculated using a one compartment model by simultaneous administration of glucose, 5 g, and ICG, 35 mg. Although the IDVG increased on the Ist post-burn day (p < 0.05), the P V-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 a nd the PV-ICG would help predict the generalized capillary protein lea kage after burns. (C) 1998 Elsevier Science Ltd for ISBI. All rights r eserved.