Plasma volume nomograms for use in therapeutic plasma exchange

Nomograms have been developed for the convenient estimation of the plasma volumes of patients undergoing therapeutic plasma exchange (TPE), based on equations employing height, body weight, and hematocrit. These nomograms are offered as an aid to prescribing continuous-flow TPE procedure exchange volumes.     

Haematological status in elite long-distance runners: influence of body composition

SUMMARY. In 10 female and eight male Danish elite middle- and long-distance runners, haematological status, including blood volume, was examined. Haemoglobin, haema-tocrit and serum (s)-ferritin concentrations were all within the normal range. In both men and women, blood volume, plasma volume and erythrocyte volume were increased in relation to various reference values. However, the runners had a low body weight due to a reduced fat level, 9-5% (7-3-15-1%) fat for the women, 5–9% (5-0-8-8%) fat (median and ranges) for the men, measured by dual-energy X-ray absorptiometry (DEXA) scanning. When the runners' body weights were ‘normalized’ to a reference population (25% fat for women, 15% fat for men), only plasma volume remained increased in relation to body weight for the women, whereas all the volumes remained increased for the men. This confirms that endurance training induces a true increased plasma volume. The lower erythrocyte volume in the women compared with the men could be a consequence of the generally poorer iron status in the women, indicating that a combination of haemolysis, menstruation and low caloric (iron) intake makes it difficult for trained women to obtain optimal effects on erythrocyte volume equal to those obtained by trained men. Furthermore, the study emphasizes the importance of taking body composition into consideration when comparing well-trained athletes with a reference population.     

Relation between plasma creatinine and body size

We studied the relationship between creatinine concentration in plasma and body size in 673 healthy individuals (385 women, 288 men). Weight, height, and skinfold thickness were measured and blood was sampled (after a short fast) for estimations of urea and creatinine in plasma. Lean body mass was calculated according to Durnin and Wormsley (Br J Nutr 1974; 32:77-97). Concentrations of urea and creatinine in plasma were significantly lower in women than in men and were significantly correlated with age in both sexes. For neither sex was there a significant correlation between lean body mass and creatinine concentration, even after we took age into account either by multiple linear-regression analysis or by considering subjects at decade intervals.     

腰椎骨质密度与年龄、性别、体质参数及腹部脂肪的相关性

目的 探讨腰椎骨质密度(BMD)与年龄、性别、体质参数及腹部皮下脂肪(SAT)、内脏脂肪(VAT)的关系。方法 纳入健康志愿者或慢性腰腿痛患者111人(男56人,女55人),测量受检者身高、体质量及腰围,计算体质指数(BMI);采用定量CT(QCT)行腹部扫描,测量L3的BMD及相应层面腹部SAT与VAT含量。将男性与女性分别分为骨质疏松组、骨量减少组和骨量正常组,分别比较3组间年龄、性别、身高、体质量、BMI、腰围、SAT和VAT的差异,对BMD与存在显著性差异的指标进行相关性分析。结果 3组男性间除年龄的差异有统计学意义(P<0.05)外,身高、体质量、BMI、腰围、SAT及VAT的差异均无统计学意义(P均>0.05);男性BMD与年龄呈负相关(r=-0.680,P<0.05)。3组女性年龄、腰围及VAT的差异有统计学意义(P均<0.05),身高、体质量、BMI、SAT差异均无统计学意义(P均>0.05);女性BMD与年龄、腰围、VAT均呈负相关(r= -0.849、-0.412、-0.501,P均<0.05)。结论 男、女性腰椎BMD与年龄均呈明显负相关,与身高、体质量、BMI无明显相关性;男性腰椎BMD与腰围、SAT与VAT均无明显相关性,但女性腰椎BMD与腰围及VAT关系密切。     

Measurement of sequential changes in plasma volume immediately after aortocoronary bypass surgery

This study assessed the reliability of 131I albumin-dilution for measuring induced changes in plasma volume (PV) immediately after coronary bypass surgery. After injection of the tracer, blood samples were collected from 18 control patients to obtain 131I albumin decay curves in the plasma. These curves were used to construct a mathematical model describing tracer decay. PV was then calculated in control patients, and in 51 study patients who received plasma expanders on the first postoperative morning. At 1, 15, 30, and 60 min after volume loading in the study group, dilution volumes were calculated as the difference between predicted and observed plasma radioactivity levels. These calculations were compared to an independent measurement of PV. This method was associated with a measurement error no greater than +/- 12% in 82% of the 51 study patients. It tended to underestimate PV by 2.4%.     

Reduction in hematocrit level after pioglitazone treatment is correlated with decreased plasma free testosterone level, not hemodilution, in women with polycystic ovary syndrome

Thiazolidinediones have gained widespread use for the treatment of type 2 diabetes mellitus and other insulin resistance states, including polycystic ovary syndrome (PCOS). In thiazolidinedione-treated patients a small reduction in hemoglobin and hematocrit levels often is observed, and this generally has been attributed to fluid retention. Because testosterone is a hematopoietic hormone, we investigated whether a reduction in plasma free testosterone concentration was associated with the decrease in hemoglobin and hematocrit levels in 22 nondiabetic women (9 with normal glucose tolerance and 13 with impaired glucose tolerance; mean age, 29 +/- 5 years; mean body mass index, 35.6 +/- 5.8 kg/m2) with PCOS who were treated with pioglitazone, 45 mg/d. Before treatment and after 4 months, subjects underwent an oral glucose tolerance test and measurement of total body water content with bioimpedance. Plasma testosterone, androstenedione, dehydroepiandrosterone sulfate, hemoglobin, and hematocrit levels were evaluated at baseline and every month for 4 months. The fasting plasma glucose concentration (98 +/- 9 mg/dL) was unchanged after pioglitazone treatment, whereas the 2-hour plasma glucose concentration declined from 146 +/- 41 to 119 +/- 20 mg/dL (P = .002). Both the free androgen index and the free testosterone levels calculated according to Vermeulen et al decreased significantly (from 14.4 +/- 7.1 to 10.6 +/- 7.8 [P = .02] and from 59.4 +/- 23.4 to 46.6 +/- 23.3 [P = .03], respectively). The plasma androstenedione level declined from 259 +/- 134 to 190 +/- 109 ng/dL (P = .01), whereas the dehydroepiandrosterone sulfate level did not change significantly (from 139 +/- 90 to 127 +/- 84 mug/dL, P = .2 [not significant]). The levels of both hemoglobin (from 13.6 +/- 1.0 to 12.8 +/- 1.1 g/dL, P = .0002) and hematocrit (from 39.7% +/- 2.2% to 37.9% +/- 2.7%, P = .002) fell slightly after 4 months of pioglitazone administration. Collectively, before and after pioglitazone administration, the plasma free testosterone level according to Vermeulen et al correlated positively with the levels of hemoglobin (r = 0.49, P < .0001) and hematocrit (r = 0.40, P < .0001), as well as the free androgen index (r = 0.38 [P < .0003] with hemoglobin and r = 0.29 [P < .006] with hematocrit); the decrement in plasma free testosterone level and free androgen index also correlated with the decrements in the levels of both hemoglobin (r = 0.51 [P = .01] and r = 0.54 [P = .01], respectively) and hematocrit (r = 0.42 [P = .05] and r = 0.50 [P = .02], respectively). Body weight increased from 90.5 +/- 17.3 to 92.4 +/- 18.8 kg after pioglitazone administration (P = .05), as did body fat content (from 42.7 +/- 15.3 to 44.8 +/- 17.1 kg, P = .03), which could explain the increase in weight, because edema did not develop in any of the subjects. Total body water content did not change significantly after pioglitazone administration (from 37.7 +/- 5.0 to 37.8 +/- 4.9 L, P = .68 [not significant]). In summary, pioglitazone treatment is associated with a mild decline in hematocrit or hemoglobin level, which is correlated with the reduction in plasma testosterone level. These results suggest that increased body water content cannot explain the reduction in hematocrit or hemoglobin level in women with PCOS. Further studies are necessary to evaluate whether the same scenario is applicable to normoandrogenic women and individuals with type 2 diabetes mellitus.     

Circulating plasma volume and renal function.

The relationships of circulating plasma volume (PV) to effective renal plasma flow and glomerular filtration rate (GFR) were investigated in reference to their interrelated changes induced by upright posture in normal subjects and patients with chronic glomerulonephritis. The following relation was obtained: (percentage change in GFR) = k(percentage change in PV). The values of k were 3.4 for the normal and 3.1 for the patients. There was no statistically significant difference between the two. On account of the above relation the recumbent level of glomerular filtration rate (GFR)r was derived from the recumbent level of circulating plasma volume (PV)r as follows: (GFR)r = Kp [(PV)r]k, where Kp is a constant. On the other hand, the decreases (percentage) in effective renal plasma flow were biphasically related to those in PV. Mean arterial pressure rose in upright posture in many cases, but its changes (percentage) showed no correlation with the changes (percentage) in GFR. These results suggest that in a small decrease in PV, GFR does not decrease with the fall in mean arterial pressure, but with the power function of PV. The possible mechanisms of these changes in renal function are examined with special reference to the structure of renal arterial system.     

Food protein effect on plasma specific gravity,plasma protein,and hematocrit value

When the protein consumption of normal human individuals is increased from 0.5, to 1.5, to 2.5 gm. of protein per kilo body weight, the specific gravity of the plasma rises and the hematocrit value falls. The analysis of variance demonstrates that the change in protein consumption is a significant but minor factor in determining the total variability of the observations. When albino rats were given diets containing a small, a moderate, and a large amount of protein, there was an increase in serum protein concentration but no change in hematocrit value. During the period over which the most rapid changes in rate of urea excretion and serum urea concentration occurred as normal human individuals passed from a 2.5 to an 0.1 gm. of protein per kilo body weight consumption, there was no change in serum protein concentration. Over a 5 day period during which a diet that was adequate in calories but almost wholly devoid of protein was taken, the serum protein concentration of normal individuals steadily rose. This was associated with a slight increase in hematocrit value but no change in blood or plasma volume. The protein effect is one of the minor factors that contribute to the variability of serum protein and hematocrit measurements in normal individuals. The general conclusion is reached that we shall have to measure the rate at which red cells and protein enter and leave the circulating blood stream before we can hope to comprehend the mechanism of the protein effect.     

妊娠期高血压疾病血液流变学与胎儿血流动力学的相关性研究

目的 通过分析妊娠期高血压疾病的血液流变学与胎儿血流动力学的相关性,预测胎儿宫内缺氧,降低围产儿死亡率。方法检测40例妊娠高血压疾病孕妇的全血比黏度高切（BVH）、全血比黏度低切（BVL）、血浆黏度（PV）、红细胞压积（HCT）、纤维蛋白原（Fib）;彩色多普勒监测胎儿脐动脉、大脑中动脉及肾动脉的血流指标。结果妊娠期高血压重度组BVH、BVL、PV、Fib、HCT大于妊娠期高血压轻度组（P〈0．05）。妊娠期高血压疾病孕妇血液流变学各值与胎儿脐动脉血流阻力指标呈正相关,与大脑中动脉血流阻力指标呈负相关,与胎儿肾动脉血流阻力指标无相关性。结论通过对妊娠期高血压孕妇血液流变学变化与胎儿血流动力学指标相关性分析和比较,为预测妊娠期高血压的严重程度提供了有益的信息,及早处理,从而减少围产儿死亡率。     

Extracellular fluid volume determined by a single injection of inulin in men with untreated essential hypertension

The extracellular volume (ECV) and plasma volume (PV) were determined simultaneously in nine men with untreated essential hypertension and in nine healthy matched control subjects, using a single injection of inulin and of 131I-labelled human serum albumin, respectively. The average mean arterial blood pressure in the hypertensive group was 178/118 mmHg. ECV was nearly the same in the two groups, viz. 151 ml/kg body weight (SD 17) in the hypertensive group compared to 147 ml/kg (SD 16) in the control group. The corresponding figures for PV were 38.2 ml/kg body weight (SD 4.7) and 43.7 ml/kg (SD 7.9) respectively (P less than 0.1). The calculated interstitial fluid volume (IV) was 113 ml/kg (SD 16) and 103 ml/kg (SD 10) (P less than 0.2). The PV/IV ratio was significantly lower (P less than 0.02) in the hypertensive group (0.34, SD 0.06) than in the normal group (0.42, SD 0.06). The difference might suggest increased transcapillary water filtration in hypertension.     

Relation of high plasma triglyceride levels associated with obesity and regional adipose tissue distribution to plasma lipoprotein-lipid composition in premenopausal women

Abdominal obesity is associated with high plasma triglyceride (TG) and with low plasma high density lipoprotein (HDL)-cholesterol (CHOL) levels. As plasma TG and HDL-CHOL are negatively correlated, the associations between obesity, the regional distribution of body fat, plasma TG levels, and plasma lipoprotein concentration and composition were studied in a sample of 76 premenopausal women (52 obese and 24 non-obese). Obese women had significantly higher plasma levels of VLDL-TG, low density lipoprotein (LDL)-CHOL, LDL-TG, LDL-apolipoprotein (apo) B and reduced HDL-CHOL levels compared to non-obese controls (p less than 0.01). However, plasma concentrations of HDL-apo A-I and HDL-TG were not different between obese and non-obese women. Partial correlation analyses revealed that both fat mass and abdominal fat accumulation significantly contributed to VLDL-TG and HDL-CHOL variances. After control for body fat mass, the waist-to-hip circumference ratio (WHR) remained significantly correlated with plasma LDL-apo B levels and with the LDL-apo B/LDL-CHOL ratio (0.01 greater than p less than 0.05). Body fat mass was, however, associated with TG enrichment of LDL (p less than 0.01). After control for WHR, body fat mass showed no significant association with plasma HDL-TG levels, whereas the WHR was positively correlated with HDL-TG levels (p less than 0.05). Partial correlation analyses indicated that adjustment for fat mass or for the WHR failed to eliminate the associations between plasma VLDL-TG levels and lipoprotein lipid composition. This study emphasizes the importance of plasma VLDL-TG level as a correlate of plasma LDL and HDL lipid composition in abdominal obesity.     

Effects of hematocrit on renal hemodynamics and sodium excretion in hydropenic and volume-expanded dogs

The effects of hematocrit on renal hemodynamics and sodium excretion were studied in anesthetized dogs during both hydropenia and volume expansion. The hematocrit was decreased by isovolemic exchange with the animal's own previously harvested plasma and increased by isovolemic exchange with fresh, washed red blood cells. Renal perfusion pressure was maintained constant throughout the experiments by the adjustment of a suprarenal aortic clamp. During hydropenia, a decrease in hematocrit was associated with an increase in sodium and potassium excretion and solutefree water reabsorption. These changes were accompained by an increase in renal plasma flow and renal blood flow and a decrease in renal vascular resistance. Glomerular filtration rate was unchanged and filtration fraction was significantly decreased as hematocrit was lowered. Increasing hematocrit during hydropenia had the opposite effects on electrolyte excretion, solute-free water reabsorption, and renal hemodynamics. In another group of animals, hematocrit was lowered during volume expansion with either saline or plasma, then returned to the control level by isovolemic exchange with washed red blood cells. This increase in hematocrit during volume expansion had a similar effect on electrolyte excretion, solute-free water reabsorption, and renal hemodynamics as during hydropenia. These results therefore suggest that acute changes in hematocrit may significantly affect sodium excretion and renal hemodynamics during both hydropenia and volume expansion. The changes in solute-free water reabsorption and potassium excretion suggest that the alterations in hematocrit may affect primarily the reabsorption of sodium in the proximal tubule. The concommitant effects of hematocrit on renal vascular resistance and filtration fraction may mediate this change in sodium reabsorption by altering hydrostatic and oncotic pressures in the peritubular circulation.     

Temporal intrapersonal physiological variability of cholinesterase activity in human plasma and erythrocytes.

Erythrocyte and plasma cholinesterase activities were measured biweekly in one group of 22 subjects for a year and daily for three weeks in another group of nine men. The average range [i.e., (range/mean) X 100] of activity of erythrocyte cholinesterase in men during a year was 8% and during three weeks was 5%. For plasma, the corresponding values were 25% and 12%. The average ranges for erythrocyte and plasma cholinesterase activity in women during a year were 12% and 24%. Erythrocyte cholinesterase activity varies less than do hematocrit, hemoglobin, or erythrocyte count.     

在线尿素清除率监测对血液透析充分性评价的研究

目的 探讨在线尿素清除率监测对血液透析充分性的评估价值.方法 选取规律血液透析患者65例,其中男38例,女27例,平均透析时间(41±29)个月.透析中血流量200～300ml/min,透析液流量500ml/min,利用在线尿素清除率监测(on-line clearance monitoring,OCM)Kt/V值;同时透析前后取全血检测尿素氮浓度等,根据单室尿素动力模型DaugirdasⅡ公式计算K t/V值,比较2种方法的相关性及不同体质量,超滤量,血流量,血红蛋白,红细胞压积对两者的影响.结果 本组65例患者利用OCM法测得的Kt/V值与采血计算法所得的K t/V值分别为(1.42±0.25)与(1.45±0.25),直线回归分析相关指数 r=0.979,P＜ 0.001.不同体质量≤60kg和＞60kg的2组患者,OCM监测的K t/V值分别为(1.50±0.27)与(1.37±0.22),t =2.09p=0.04采血计算Kt/V值(1.54±0.27)与(1.40±0.22),t=2.23,P=0.03 2者有显著差别.不同超滤量<3kg和≥3kg的2组患者,K t/V值无显著差别OCM法比较t=-1.34,P =0.19采血计算法比较t=-1.52,P=0.13.不同血流量200～250ml/min和260～300ml/min的2组患者,Kt/V值有显著差别OCM法比较t=-9.11p=0.01采血计算法比较 t=-9.13,P=0.01.不同血红蛋白水平Hgb≤110g及Hgb＞110g的2组患者,K t/V值无显著差异OCM法比较t=0.33,P =0.74采血计算法比较t=-0.15,P =0.88.不同红细胞压积水平HCT≤33%及HCT＞33%的2组患者,Kt/V值无显著差异OCM法比较t=-0.50,P =0.62采血计算法比较t=-0.81,P =0.43.结论 采用OCM监测可以很好的反映患者单次透析的尿素清除,有利于短期内调整透析处方,并结合其结果制定个体化的透析方案,以保证患者的透析充分性.     

Effect of the hematocrit and its correction on the relationship between blood tacrolimus concentrations obtained using the microparticle enzyme immunoassay (MEIA) and enzyme multiplied immunoassay technique (EMIT)

The Abbott microparticle enzyme immunoassay (MEIA) and the Dade Behring enzyme multiplied immunoassay technique (EMIT) are the most frequently used methods in the therapeutic drug monitoring of tacrolimus; however, a hematocrit-dependent interference for the MEIA has been described. In 244 whole blood samples from patients with liver (n=152) and kidney (n=92) transplants, the MEIA/EMIT ratio presented a highly significant negative correlation with the hematocrit (r = -0.482, p < 0.001). On distributing the samples into three groups with a hematocrit of less than 30%, 30-40%, and higher than 40%, different regression equations were found between the results of MEIA and EMIT and demonstrate the different effect of the hematocrit on both immunoassays. Correcting the MEIA results by calculation for a hematocrit of less than 30% and higher than 40% (Hermida et al. Clin Lab 2005; 51: 43-45) led to a regression with EMIT that was similar to that found between MEIA and EMIT for the group of samples with a hematocrit of 30-40%. Furthermore, the corrected MEIA/EMIT ratio had a poor correlation with the hematocrit (r = 0.149, p < 0.05). In 95 samples with a hematocrit of less than 25% (n=73) and higher than 40% (n=22) we also determined the tacrolimus levels using the modified MEIA method to correct hematocrit interference, as proposed by Tomita et al. (Ther Drug Monit 2005; 27: 94-97). In the samples with a hematocrit of less than 25%, correcting the MEIA results by calculation produced results that were similar and had a high correlation coefficient (r = 0.954, p < 0.001) to those of the modified MEIA method, whose application as a routine practice is more expensive and laborious. Calculation of the corrected MEIA values in anemic patients may be useful for the therapeutic monitoring of tacrolimus.     

Association between magnesium, calcium, phosphorus, copper, and zinc in umbilical cord plasma and erythrocytes, and the gestational age and growth variables of full-term newborns.

We determined reference values in umbilical cord plasma and erythrocytes for magnesium, total calcium, phosphorus, copper, and zinc, and then calculated correlations and stepwise-regression equations in 66 white full-term newborn infants (35 boys, 31 girls). Only infants meeting certain optimal criteria and benefiting from excellent maternal conditions and uncomplicated pregnancies were included. There were no significant sex-related differences at birth among the variables studied. Gestational age was positively correlated with erythrocyte zinc (P less than 0.001), and plasma calcium was positively correlated with erythrocyte copper (P less than 0.001). Plasma copper proved to be the most significant variable in the stepwise-regression equation for birth height as the dependent variable. The most significant regressors accounting for birth weight were erythrocyte zinc followed by plasma zinc.     

Effects of age and sex on piroxicam disposition

Piroxicam kinetics were studied after a single, oral, 20-mg capsule was taken by 12 young (six women, six men) and 13 elderly (seven women, six men) healthy subjects. Plasma samples were drawn for 216 hr after dosing. Plasma protein binding was studied in vitro by equilibrium dialysis and piroxicam concentrations were measured by HPLC with ultraviolet detection. The apparent volume of distribution was smaller in elderly women (7.8 +/- 0.4 l) than in young men (11.3 +/- 0.3 l) and elderly men (10.8 +/- 0.8 l). There were no such differences when the apparent volume of distribution was normalized for total body weight. There was a strong correlation between total body weight and apparent volume of distribution in all subjects (r = 0.83). Plasma protein binding of piroxicam ranged from 98.90% to 99.54% bound and was not affected by age or sex. Piroxicam body clearance in elderly women (0.026 +/- 0.002 ml/min/kg) was approximately 33% lower than in young women (0.039 +/- 0.003 ml/min/kg). This difference was reflected in different t1/2s of 61.7 and 44.9 hr. Predicted steady-state plasma piroxicam concentrations were 5.7 micrograms/ml in young women, 5.4 micrograms/ml in young men, 5.7 micrograms/ml in elderly men, and 9.3 micrograms/ml in elderly women. The high value in elderly women results from the lower piroxicam body clearance and total body weight. Our data suggest that healthy elderly women eliminate piroxicam at a slower rate than healthy young women. The clinical significance of these data needs to be assessed in patients.     

Stroke volume measurements by electrical bioimpedance and echocardiography in healthy volunteers

To evaluate the validity of three equations for estimation of thoracic electrical field size in a new bioimpedance algorithm, stroke volume (SV) as calculated by these equations was compared with that calculated by Doppler echocardiography in 48 healthy volunteers, both lean and obese. When the volume of electrically participating tissue was estimated from body height (modified Sramek) or body height corrected for body habitus (Sramek-Bernstein), there was considerable variation between bioimpedance and Doppler stroke volumes. When the volume of electrically participating tissue was estimated from the actual measurement of the height of the thorax and the circumference at the base of the thorax, the variation in SV differences decreased substantially (Sramek equation), although still considerable for clinical use, and there was no relationship between SV thus obtained and body habitus. Analysis of calculated stroke indices derived by our Doppler echocardiographic standard, as compared with values in the literature, revealed a systematic underestimation. We conclude that the original Sramek equation systematically underestimates SV by 15% to 20%, and the modified Sramek and Sramek-Bernstein equations systematically underestimates SV by 15% to 20%, and the modified Sramek and Sramek-Bernstein equations systematically overestimate SV in females by about 15%, but provide SV values in males in the predicted range. Further studies on the current assumption that the electrical field size is a truncated cone may improve precision of the bioimpedance method.     

A modified method of measuring plasma volume with indocyanine green: reducing the frequency of blood sampling while maintaining accuracy

Among various methods for measuring the plasma volume (PV), the indocyanine green (ICG) dilution technique is a relatively less invasive method. However, the ICG method is rather cumbersome because 10 blood samples need to be obtained within a short time after ICG administration. Thus, reducing the frequency of blood sampling while maintaining the accuracy would facilitate plasma volume measurement in clinical situations. We here developed a modified method to measure plasma volume using 2260 ICG plasma concentration data from 115 surgical patients. The mean relative error (MRE) and the percentage of cases with relative error (RE) greater than 5% in total (PRE) were used to quantify the difference between plasma volumes obtained by the original and modified methods. RE was determined as follows. RE(%)?=?(PV obtained by original method (PV_original)—PV obtained by modified method (PV_modified))/PV_original?×?100. PV_modified was assumed to be equal to PV_original when the RE was?<?5%. When the number of samples selected for the plasma volume estimation was 4 or less, the PRE was mostly 10% or more. Five out of the 10 blood samples (order: 1st, 2nd, 3rd, 9th, and 10th) showed similar accuracies with the plasma volume obtained by the original method (original: 2.72?±?0.64 l, modified: 2.72?±?0.65 l). This modified method may be able to aptly replace the original method and lead to a wider clinical application of the ICG dilution technique. Further validation is needed to determine if the results of this study may be applied in other populations.