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Minimally invasive assessment of hepatic function in children with indocyanine green elimination: a validation study

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@article{8824dda3a05d4941b16deee169678c7d,
title = "Minimally invasive assessment of hepatic function in children with indocyanine green elimination: a validation study",
abstract = "OBJECTIVES: Pediatric liver disease (PLD) covers a variety of etiologies and severities, from mild temporary illness to diseases with fatal outcomes. There is a demand for minimally invasive and reliable measures for assessment of the severity of PLD. Indocyanine green (ICG) elimination kinetics to estimate hepatic function has been used in adults for decades, however, due to invasiveness, the use in PLD is still limited. The aim of the present study was to evaluate minimally invasive estimation of ICG elimination by pulse spectrophotometry (ICGLi), in comparison with traditional spectrophotometry using serial blood samples (ICGbs).METHODS: One hundred children aged 0-18 years were included in the study. ICG elimination kinetics was measured with ICGLi and ICGbs, and results compared by failure rates, mean difference, limits of agreement, Bland Altman plots and linear regression analysis. Plasma disappearance rates (PDRLi and PDRbs) were used for comparison.RESULTS: One hundred and twelve simultaneous measurements in 87 patients were performed successfully. Mean difference for PDR ({\%}/min) was 3.58 (95{\%} CI 2.69; 4.47). Limits of agreement were -5.06; 12.22. A linear correlation between the two methods with a regression coefficient of 0.83 (SE 0.02 95{\%} CI 0.80; 0.87) was found. For conversion we computed the following equation; PDRbs = 0.83 × PDRLi.CONCLUSIONS: The present study shows that ICG PDR can be obtained by a minimally invasive method and thus replace measures by serial blood samples in children with liver disease of different etiologies and severities. However, a systematic relative difference between the two methods exists. Our proposed correction factor needs to be validated in larger cohorts.",
keywords = "autoimmune hepatitis, biliary atresia, indocyanine green, liver function tests, liver transplantation, Pediatric liver disease",
author = "Jon Nielsen and Nikolaj Nerup and S{\o}ren M{\o}ller and {de Nijs}, Robin and Allan Rasmussen and {Bo Svendsen}, Lars and Kjaer, {Mette Skalsh{\o}i} and {Brix Christensen}, Vibeke and Lise Borgwardt",
year = "2019",
month = "4",
doi = "10.1080/00365521.2019.1591497",
language = "English",
volume = "54",
pages = "485--491",
journal = "Scandinavian Journal of Gastroenterology",
issn = "0036-5521",
publisher = "Taylor & Francis",
number = "4",

}

RIS

TY - JOUR

T1 - Minimally invasive assessment of hepatic function in children with indocyanine green elimination

T2 - a validation study

AU - Nielsen, Jon

AU - Nerup, Nikolaj

AU - Møller, Søren

AU - de Nijs, Robin

AU - Rasmussen, Allan

AU - Bo Svendsen, Lars

AU - Kjaer, Mette Skalshøi

AU - Brix Christensen, Vibeke

AU - Borgwardt, Lise

PY - 2019/4

Y1 - 2019/4

N2 - OBJECTIVES: Pediatric liver disease (PLD) covers a variety of etiologies and severities, from mild temporary illness to diseases with fatal outcomes. There is a demand for minimally invasive and reliable measures for assessment of the severity of PLD. Indocyanine green (ICG) elimination kinetics to estimate hepatic function has been used in adults for decades, however, due to invasiveness, the use in PLD is still limited. The aim of the present study was to evaluate minimally invasive estimation of ICG elimination by pulse spectrophotometry (ICGLi), in comparison with traditional spectrophotometry using serial blood samples (ICGbs).METHODS: One hundred children aged 0-18 years were included in the study. ICG elimination kinetics was measured with ICGLi and ICGbs, and results compared by failure rates, mean difference, limits of agreement, Bland Altman plots and linear regression analysis. Plasma disappearance rates (PDRLi and PDRbs) were used for comparison.RESULTS: One hundred and twelve simultaneous measurements in 87 patients were performed successfully. Mean difference for PDR (%/min) was 3.58 (95% CI 2.69; 4.47). Limits of agreement were -5.06; 12.22. A linear correlation between the two methods with a regression coefficient of 0.83 (SE 0.02 95% CI 0.80; 0.87) was found. For conversion we computed the following equation; PDRbs = 0.83 × PDRLi.CONCLUSIONS: The present study shows that ICG PDR can be obtained by a minimally invasive method and thus replace measures by serial blood samples in children with liver disease of different etiologies and severities. However, a systematic relative difference between the two methods exists. Our proposed correction factor needs to be validated in larger cohorts.

AB - OBJECTIVES: Pediatric liver disease (PLD) covers a variety of etiologies and severities, from mild temporary illness to diseases with fatal outcomes. There is a demand for minimally invasive and reliable measures for assessment of the severity of PLD. Indocyanine green (ICG) elimination kinetics to estimate hepatic function has been used in adults for decades, however, due to invasiveness, the use in PLD is still limited. The aim of the present study was to evaluate minimally invasive estimation of ICG elimination by pulse spectrophotometry (ICGLi), in comparison with traditional spectrophotometry using serial blood samples (ICGbs).METHODS: One hundred children aged 0-18 years were included in the study. ICG elimination kinetics was measured with ICGLi and ICGbs, and results compared by failure rates, mean difference, limits of agreement, Bland Altman plots and linear regression analysis. Plasma disappearance rates (PDRLi and PDRbs) were used for comparison.RESULTS: One hundred and twelve simultaneous measurements in 87 patients were performed successfully. Mean difference for PDR (%/min) was 3.58 (95% CI 2.69; 4.47). Limits of agreement were -5.06; 12.22. A linear correlation between the two methods with a regression coefficient of 0.83 (SE 0.02 95% CI 0.80; 0.87) was found. For conversion we computed the following equation; PDRbs = 0.83 × PDRLi.CONCLUSIONS: The present study shows that ICG PDR can be obtained by a minimally invasive method and thus replace measures by serial blood samples in children with liver disease of different etiologies and severities. However, a systematic relative difference between the two methods exists. Our proposed correction factor needs to be validated in larger cohorts.

KW - autoimmune hepatitis

KW - biliary atresia

KW - indocyanine green

KW - liver function tests

KW - liver transplantation

KW - Pediatric liver disease

UR - http://www.scopus.com/inward/record.url?scp=85063591124&partnerID=8YFLogxK

U2 - 10.1080/00365521.2019.1591497

DO - 10.1080/00365521.2019.1591497

M3 - Journal article

VL - 54

SP - 485

EP - 491

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 4

ER -

ID: 56909157