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LiMON Technology

Non-invasive monitoring of liver function or splanchnic perfusion

LiMON is the technology for non-invasive measurement of liver function and splanchnic perfusion monitoring, based on elimination of Indocyanine Green (ICG). ICG is a fluorescent dye. It is intended for intravenous injection. The absorption and emission spectrum of ICG are both in the near infrared and infrared range. For this reason it can be detected and quantified by optical procedures. 

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Non-invasive global liver function assessment at the bedside with Limon
LiMON detects the elimination of diagnostic dye indocyanine green by modified pulse oximetry.
Non-invasive global liver function assessment at the bedside

Non-invasive global liver function assessment at the bedside

Measurement can be performed non-invasively through the skin. Due to the fact that ICG is eliminated in the liver exclusively, the detection rate is a valuable indicator for global liver function. The diagnostic importance of the ICG detection as an indicator for the liver function has been confirmed in numerous scientific publications and has been established for more than 30 years.

Advantages

  • Early detection of liver dysfunction
  • Reflects actual liver function
  • Non-invasive measurement
  • Available at the bedside

Methodology

The LiMON measurement is based on the elimination of the diagnostic drug indocyanine green (ICG). ICG is injected into a vein, binds immediately and completely to plasma proteins and is exclusively eliminated from the blood by the liver. This elimination is quite fast with a half life time of 3.5 to 4 minutes.

icg_elimination_e_500px_new.jpg
Liver app

LiMON Module and Sensor

limon module

LiMON Module

  • Plasma Disappearance Rate of Indocyanine Green (PDR/ICG)
  • Continuous SpO2* Measurement
  • Non-invasive
  • Easy application
  • Reusable

*This parameter will not be available on the PulsioFlex monitor from software version 5.0

limon sensor

LiMON Sensor: Re-useable finger sensor

  • Non-invasive liver function Monitoring
  • Continuous SpO2* Monitoring

Consumables: Indocyanine Green

*This parameter will not be available on the PulsioFlex monitor from software version 5.0

Intensive Care

  • LiMON® immediately detects liver hypoperfusion
  • Superior in predicting the survival probability[1]
  • PDRICG of less than 16%/min requires intervention[2]
  • Optimised fluid therapy by LiMON® in combination with PiCCO[3]
  • Serves as an indicator of regional perfusion

Liver Transplantation

  • Peri-operative evaluation of graft quality and function to reduce the probability of need for re-transplantation[4]
  • Provides a reliable indicator of graft outcome early after surgery[5]
  • Helps to identify complications prematurely[6]

Liver Resection

  • LiMON® provides decisive parameters in pre-operative risk assessment
  • A low PDRICG excludes patients from major resection[7]
  • Early identification of post-operative liver dysfunction
  • Predictive power significantly higher than conventional markers[7]

Cardiac Surgery

  • Pre-, peri- and early postoperative measurements of PDRICG can serve as a predictor of prolonged ICU treatment[8]
  • Goal-directed strategies aimed at improving the PDRICG can be considered in at risk cardiac surgical patients to improve outcome[8]

Hepatology

  • Valuable tool for the evaluation of prognosis in liver cirrhosis[1]
  • Enables prediction of survival in intermediate advanced liver disease[1]
  • Estimation of functional liver cell mass

Improve your knowledge with our eLearning and training courses

At Getinge Educational Institute, we have dedicated material for topics related to Intensive Care, Cardiovascular Procedures, Operating Room and Sterile Processing. We can support you with information about current technologies and best practices to boost your performance and productivity.

For more information about our onsite events or remote trainings, you can also contact your local sales & service representative.

Getinge Educational Institute

  1. 1. Zipprich A. et al., Incorporating indocyanin green clearance into the Model for End Stage Liver Disease (MELD-ICG) improves prognostic accuracy in intermediate to advanced cirrhosis. Gut 2010, 59(7): 963-968.

  2. 2. Sakka S. G. et al., Prognostic value of the indocyanine green plasma disappearance rate in critically ill patients. Chest 2002, 122(5): 1715-1720.

  3. 3. Sakka S. G. et al., Non-invasive liver function monitoring by indocyanine green plasma disappearance rate in critically ill patients. Int J Intensive Care 2002, 9(2):66-72.

  4. 4. Mandel M. S. et al., Elimination of indocyanine green in the perioperative evaluation of donor liver function. Anesth Analg 2002, 95(5): 1182-1184.

  5. 5. Tsubono T. et al., Indocyanine green elimination test in orthotopic liver recipients. Hepatology 1996, 24(5): 1165-1171.

  6. 6. Levesque E. et al., Plasma disappearance rate of indocyanine green: a tool to evaluate early graft outcome after liver transplantation. Liver Transpl 2009, 15(10):1358-1364.

  7. 7. Scheingraber S. et al., Indocyanine green disappearance rate is the most useful marker for liver resection. Hepatogastroenterology 2008, 55(85): 1394-1399.

  8. 8. Sander M. et al., Perioperative indocyanine green clearance is predictive for prolonged intensive care unit stay after coronary artery bypass grafting - an observational study. Crit Care 2009, 13(5): R149.

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