Monitoring des total hepatischen Blutflusses unter Einsatz der transösophagealen Echographie im Vergleich zur Bestimmung mittels Indocyaningrün (ICG)-Clearance über einen Lebervenenkatheter: ein neues nicht-invasives Verfahren?
LicenseStandard (Fassung vom 03.05.2003)
OBJECTIVE: In critically ill patients total hepato-splanchnic blood flow is usually determined using a primed infusion of indocyaninegreen (ICG) with hepatic venous sampling. The hepatic venous catheterization is an invasive procedure and we could recently demonstrate in an animal model that hepato-splanchnic blood flow could be reliably determined with transesophageal echography (TEE). In this study we investigated whether TEE is a non-invasive method for bedside assessment of hepatic venous blood flow in clinical practice. PATIENTS: Thirteen anaesthetized and ventilated critically ill patients in whom hepato-splanchnic blood flow was augmented by a dobutamine infusion were studied. METHODS and RESULTS: TEE-derived calculations of hepatic venous blood flow were compared with hepato-splanchnic blood flow (Qspl) measurements using a primed infusion of ICG with hepatic venous sampling. Parameters were determined at baseline as well as after modulating splanchnic blood flow by the infusion of dobutamine. Diameter (d) and velocity time integral of all 3 hepatic veins were determined by TEE, heart rate was derived from ECG and flow subsequently calculated.Correlation analysis of TEE and ICG values showed non significant relationship. CONCLUSION: TEE do not offer an non-invasive approach for monitoring changes in hepato-splanchnic blood flow in critically ill patients.
Subject HeadingsTransösophageale Ultraschallkardiographie [GND]
Echocardiography, transesophageal [MeSH]