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By Kai Licha (auth.), Prof. Dr. Werner Krause (eds.)


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Consequently, several techniques to measure ICG concentration in real-time have been explored. Certain properties of ICG summarized below have endeared its widespread use in hepatology: (1) Lipophilic-hydrophilic character: ICG is an amphiphilic molecule consisting of a lipophilic polyaromatic polyene core and a water-solubilizing sulfonate group (Fig. 7). As a surfactant, ICG exists predominantly in a monomeric form at low concentrations (< 5 µM) but rapidly aggregates at higher concentrations (100 µM) [132].

It is primarily metabolized in the liver by cytochrome P450 enzymes to give N-demethylated xanthine and few other metabolites (Fig. About 17 caffeine metabolites have been identified in humans [51]. 38 S. Achilefu · R. B. Dorshow Fig. 2. Caffeine and some metabolites: TMX, trimethylxanthine; DMX, dimethylxanthine; MMX, monomethylxanthine Due to its high oral availability, caffeine is normally dispensed orally but has also been administered intravenously to circumvent complication by oral delivery in critically ill patients [51].

64 5 Conclusions and Future Direction 6 References . . . . . . . . . . . . . . . . 65 Abbreviations CBT CT DMSA DMX DOTA DTPA EDTA FITC GEC Caffeine breath test Computed tomography Dimercaptosuccinic acid Dimethylxanthine Cyclododecane-1,4,7,10-tetraazaacetic acid Diethylenetriaminepentaacetic acid Ethylenediaminetetraacetic acid Fluorescein isothiocyanide Galactose elimination capacity Dynamic and Continuous Monitoring of Renal and Hepatic Functions with Exogenous Markers GFR HAMC ICG MAMC MEGX MMX MRI NIRS OIH PAH PET SPECT TMX 33 Glomerular filtration rate 7-hydroxy-4-(aminomethyl)coumarin Indocyanine green 7-Methoxy-4-(aminomethyl)coumarin monoethylglycinexylidine Monomethylxanthine Magnetic resonance imaging Near infrared spectroscopy o-Iodohippuric acid p-Amino hippuric acid Positron emission tomography Single photon computed tomography Trimethylxanthine 1 Introduction This chapter reviews advances in the use of exogenous organ function-specific tracers for dynamic and continuous monitoring of renal and hepatic functions.

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