Hepatic plasma flow estimated according to fick's principle in patients with hepatic encephalopathy: Evaluation of indocyanine green and D-sorbitol as test substances

Abstract

The magnitude of hepatic plasma flow in patients with liver failure and hepatic encephalopathy (HE) is unknown because a reliable flow estimate has not been available. The purpose of this study was to estimate hepatic plasma flow in patients with HE and to evaluate indocyanine green (ICG) and sorbitol as test compounds. Fourteen patients with acute liver failure (ALF) and nine patients with chronic liver failure (CLF), all with HE grade II or more, were studied. After hepatic vein catheterization, hepatic plasma flow was estimated by use of constant infusion, simultaneous arterial and hepatic vein concentration measurements, and calculated according to Fick's principle. The hepatic extraction fraction of D-sorbitol 0.179 ± 0.144 (mean ± SD) was higher than the hepatic extraction fraction of ICG 0.054 ± 0.085 (P