Indocyanine green kinetics characterize blood volume and flow distribution and their alteration by propranol

Claus U. Niemann, Thomas K. Henthorn, Tom C. Krejcie, Colin A. Shanks, Cheri Enders-Klein, Michael J. Avram*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background and objectives: Although indocyanine green can be used to estimate cardiac output and blood volume independently, a recirculatory multicompartmental indocyanine green model enables description of these and additional intravascular events. Our model was used to describe the effect of propranolol on blood volume and flow distribution in humans. Methods: Indocyanine green disposition was determined twice in four healthy adult men, once during a propranolol infusion that decreased cardiac output. After injection of indocyanine green, arterial blood was collected frequently for 2 minutes and less frequently thereafter. Plasma indocyanine green concentrations were measured by HPLC. The recirculatory pharmacokinetic model incorporates data from both the initial transient oscillations and the later post-mixing portions of the blood indocyanine green concentration versus time curves to characterize not only blood volume and cardiac output but also their distribution among a central blood volume and fast and slow peripheral volumes in lumped parallel circuits. Flow through the central circulation (cardiac output) is described by two parallel Erlang distribution functions generated by two linear chains of compartments in parallel. Results: Propranolol reduced cardiac output from 10.6 to 4.1 L/min. Most of the decrease in cardiac output was at the expense of blood flow to the fast peripheral circuit, which represented nonsplanchnic circulation. Propranolol also reduced the blood volume of the fast peripheral circuit by more than half. Conclusion: Our indocyanine green model is able to derive estimates of blood volume and cardiac output, as well as their systemic distribution during different physiologic conditions.

Original languageEnglish (US)
Pages (from-to)342-350
Number of pages9
JournalClinical pharmacology and therapeutics
Issue number4
StatePublished - 2000

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology


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