Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure
<p>Abstract</p> <p>Background</p> <p>In patients presenting with acute liver failure (ALF) prediction of prognosis is vital to determine the need of transplantation. Based on the evidence that plasma disappearance rate of indocyanine green (ICG-PDR) correlates with live...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-12-01
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| Series: | BMC Gastroenterology |
| Online Access: | http://www.biomedcentral.com/1471-230X/9/91 |
| _version_ | 1818344608503955456 |
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| author | Encke Jens Stremmel Wolfgang Sieg Olivia Merle Uta Eisenbach Christoph |
| author_facet | Encke Jens Stremmel Wolfgang Sieg Olivia Merle Uta Eisenbach Christoph |
| author_sort | Encke Jens |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>In patients presenting with acute liver failure (ALF) prediction of prognosis is vital to determine the need of transplantation. Based on the evidence that plasma disappearance rate of indocyanine green (ICG-PDR) correlates with liver cell function, we evaluated the ability of ICG-PDR measured by pulse dye densitometry to predict outcome in patients with acute liver failure.</p> <p>Methods</p> <p>Prospectively markers of hepatocellular injury, synthesis and excretion, including ICG-PDR were measured daily until liver transplantation, death, discharge from intensive care unit, or up to 7 days in 25 patients with acute liver failure. Receiver operating curve (ROC) analysis was performed to assess the value of ICG-PDR to predict outcome in ALF.</p> <p>Results</p> <p>The 25 patients analyzed included 18 that recovered spontaneously and 7 that underwent liver transplantation (n = 6) or died (n = 1). Causes of ALF included viral hepatitis (n = 4), toxic liver injury (n = 15), ischemic liver injury (n = 2), and cryptogenic liver failure (n = 4). King's college criteria were fulfilled in 85.7% of patients not recovering spontaneously and in 16.7% of patients recovering spontaneously. The mean ICG-PDR measured on day 1 in patients recovering spontaneously was 12.0 ± 7.8%/min and in patients not recovering spontaneously 4.3 ± 2.0%/min (P = 0.002). By ROC analysis the sensitivity and specificity of an ICG-PDR value ≤ 6.3%/min on study day 1 were 85.7% and 88.9%, respectively, for predicting a non spontaneous outcome in ALF.</p> <p>Conclusion</p> <p>ICG-PDR allows early and sensitive bedside assessment of liver dysfunction in ALF. Measurement of ICG-PDR might be helpful in predicting the outcome in acute liver failure.</p> <p>Trial registration</p> <p>Clinicaltrials.gov, NCT 00245310</p> |
| first_indexed | 2024-12-13T16:49:11Z |
| format | Article |
| id | doaj.art-febad8f1aa754c2bbbb69a1aa8b4dd92 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-13T16:49:11Z |
| publishDate | 2009-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-febad8f1aa754c2bbbb69a1aa8b4dd922022-12-21T23:38:05ZengBMCBMC Gastroenterology1471-230X2009-12-01919110.1186/1471-230X-9-91Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failureEncke JensStremmel WolfgangSieg OliviaMerle UtaEisenbach Christoph<p>Abstract</p> <p>Background</p> <p>In patients presenting with acute liver failure (ALF) prediction of prognosis is vital to determine the need of transplantation. Based on the evidence that plasma disappearance rate of indocyanine green (ICG-PDR) correlates with liver cell function, we evaluated the ability of ICG-PDR measured by pulse dye densitometry to predict outcome in patients with acute liver failure.</p> <p>Methods</p> <p>Prospectively markers of hepatocellular injury, synthesis and excretion, including ICG-PDR were measured daily until liver transplantation, death, discharge from intensive care unit, or up to 7 days in 25 patients with acute liver failure. Receiver operating curve (ROC) analysis was performed to assess the value of ICG-PDR to predict outcome in ALF.</p> <p>Results</p> <p>The 25 patients analyzed included 18 that recovered spontaneously and 7 that underwent liver transplantation (n = 6) or died (n = 1). Causes of ALF included viral hepatitis (n = 4), toxic liver injury (n = 15), ischemic liver injury (n = 2), and cryptogenic liver failure (n = 4). King's college criteria were fulfilled in 85.7% of patients not recovering spontaneously and in 16.7% of patients recovering spontaneously. The mean ICG-PDR measured on day 1 in patients recovering spontaneously was 12.0 ± 7.8%/min and in patients not recovering spontaneously 4.3 ± 2.0%/min (P = 0.002). By ROC analysis the sensitivity and specificity of an ICG-PDR value ≤ 6.3%/min on study day 1 were 85.7% and 88.9%, respectively, for predicting a non spontaneous outcome in ALF.</p> <p>Conclusion</p> <p>ICG-PDR allows early and sensitive bedside assessment of liver dysfunction in ALF. Measurement of ICG-PDR might be helpful in predicting the outcome in acute liver failure.</p> <p>Trial registration</p> <p>Clinicaltrials.gov, NCT 00245310</p>http://www.biomedcentral.com/1471-230X/9/91 |
| spellingShingle | Encke Jens Stremmel Wolfgang Sieg Olivia Merle Uta Eisenbach Christoph Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure BMC Gastroenterology |
| title | Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure |
| title_full | Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure |
| title_fullStr | Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure |
| title_full_unstemmed | Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure |
| title_short | Sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure |
| title_sort | sensitivity and specificity of plasma disappearance rate of indocyanine green as a prognostic indicator in acute liver failure |
| url | http://www.biomedcentral.com/1471-230X/9/91 |
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