ICG | Frequently Asked Questions


Download ICG FAQ’s pamphlet here.

What is Indocyanine Green Dye?

Indocyanine Green is a cyanine dye used in medical diagnostics. It has a peak spectral absorption at about 800 nm. These infrared wavelengths penetrate to a depth of 1.5cm into the tissue, allowing ICG imaging. ICG binds to plasma proteins and becomes confined to the vascular system. It has a half-life of 3 to 4 minutes and is removed from circulation exclusively by the liver and secreted into the bile.

ICG-PULSION is a sterile, lyophilized green powder containing 25mg or 50mg of Indocyanine Green with no more than 5% sodium iodide. Indocyanine Green is dissolved using Sterile Water for Injection, and is to be administered intravenously.

What about allergic reactions to sodium iodide contained in ICG?

ICG-PULSION contains up to 5% sodium iodide (NaI). Iodide is a naturally occurring salt required by the human body for normal function. Iodide not used by the body is expelled through urine. One vial of ICG contains approximately three times the daily recommended intake of NaI.3

A reaction to x-ray contrast agents is often referred as an “Iodine Allergy”. However, the actual incidence of a true iodide allergy is extremely rare. ICG should be used with caution in patients who have a history of allergy to iodides, or iodine.2

How often can you take measurements using ICG?

With normal liver function, the plasma half-life of ICG is 3-4 minutes. Measurements can therefore be repeated after 15-20 minutes.

How long after the injection does it take before the ICG can be visualized?

Depending on the imaging method and the tissue to be imaged, after intravenous injection of ICG, the fluorescence image can be observed in less than one (1) minute.

How is ICG prepared and what is the recommended dosage?

ICG should be dissolved with sterile water for injection to a final concentration of 5 mg per 1 mL. Saline should not be used as this can lead to clumping of the ICG molecules.
The dosage depends on the intended application and the weight of the patient. For details, please see the instructions for use below.

Single dose per measurement in adults, elderly and children

Application Bolus Injection
Cardiac measurement
Tissue perfusion diagnostics
Cerebral blood flow
0.1 to 0.3 mg/kg body weight
Liver function diagnostics 0.25 - 0.5 mg/kg body weight
Ophthalmic angiography 0.1 to 0.3 mg/kg body weight

Total maximum daily dose of ICG-PULSION

Age of the Patient Maximum Daily Dose
Adults, elderly, adolescents(11-18 years) < 5 mg/kg body weight
Children (2-11 years) < 2.5 mg/kg body weight
Children (0-2 years) < 1.25 mg/kg body weight
Can you use a single bottle of ICG on more than one patient?

No. ICG is a sterile product which is injected intravenously. It is intended for single use application only.

How long does ICG last once it has been dissolved?

ICG should be kept away from light and used immediately after it is reconstituted, as in its liquid form it is unstable.

What happens to ICG when it is injected?

The ICG binds rapidly and completely to plasma proteins (primarily albumin).2 There is no reabsorption in the gut. It is removed entirely through the liver and eliminated through the bile. The substance is not metabolized or broken down.

Where do you inject ICG?

ICG is approved for intravenous injection into any vein.

In which applications is ICG currently being used?

Cardiac, circulatory and micro-circulatory diagnostics:

  • measurement of cardiac output and stroke volume
  • measurement of circulating blood volumes
  • measurement of cerebral perfusion

Liver function diagnostics:

  • measurement of excretory function of the liver

Ophthalmic angiography diagnostics:

  • measurement of perfusion of the choroid
Where is ICG available?

The Marketing Authorization approval for Indocyanine Green exists for Austria, Belgium, Germany, Italy, Netherlands, Portugal, Sweden, Russia, United Kingdom and United States.

To find the Distributor or to check the availability in your country please contact us.

Diagnostic Green
Otto-Hahn-Straße 20
85609 Aschheim-Dornach Germany
Main: +0 49 89 1241 477-20
Fax: +0 49 89 1241 477 -29
E-mail: info@diagnosticgreen.com
www.diagnosticgreen.com

 


References


1. Boehm I et. al. Seafood allergy and radiocontrast mediaL are physicians propogating a myth? Am J Med.2008; 121(8):p.e19.

2. Baker K.J. et. al. Binding of suldobromophthalein (BSP) sodium and indocyanine green (ICG) by plasma alpha- 1 lipiproteins. Proc Soc Exp Biol Med. (1966 Aug); 122(4):p957-63.

3. German society for nutrition. Reference values.