[Indocyanine green plasma disappearance rate: estimation of abdominal perfusion disturbances]

Increased intraabdominal pressure (IAP) and abdominal compartment syndrome (ACS) are diseases which are often underestimated with respect to incidence and prognosis especially in critically ill patients. The clinical gold standard for the determination of IAP is the urinary bladder measurement technique. For assessment of hepatosplanchnic perfusion the indocyanine green plasma disappearance rate (ICG-PDR) has recently become a clinically attractive method. In this investigation a decrease in splanchnic perfusion caused by increased IAP was observed in critically ill patients with abdominal focused sepsis or postoperative systemic inflammatory response syndrome (SIRS). It was found that the reduction of ICG-PDR as a measure of splanchnic blood flow correlated with the increase of IAP, i.e. increased IAP is associated with lower ICG-PDR. Furthermore, the data suggest that a relevant decrease of splanchnic blood flow may appear even during lower IAP than previously assumed.