Turning brownfields green again.

Background: Hot compresses on the right upper abdomen are used as support for patients with liver diseases in Germany. The study was designed to determine, whether they affect hepatic blood flow. Methods: Single dose kinetics of indocyanine green (ICG) were studied in 13 healthy subjects with or without hot compresses on the right upper abdomen over 40 minutes. The time interval between the investigations was 8 days, the sequence was randomly assigned. Results: Within non-linear kinetic analyses the area under the curves (AUC) were 23% (95% confidence interval [CI]: 5–37%) lower with hot compresses. In the initial phase, however, no differences were detected (p = 0.295). The differences occurred only in the late phase after 30–40 minutes, when the genuine ICG is eliminated from the plasma and only the degradation product remains. Conclusion: Hot compresses have no effect on ICG elimination in healthy subjects but seem to affect the elimination of ICG metabolites. Trial registration: ClinicalTrials.gov NCT00484913 Background Application of hot moist compresses on the upper abdomen is used in nursing care, physiotherapy and rehabilitation clinics as support for patients with liver diseases in Germany [1-4]. Heat is maintained by hot bottles and wrapping the patient in dry cover sheets. Up to now, there is no scientific evidence whether these applications are effective or whether there is any effect on the liver at all. Aminotransferase levels remained unchanged during abdominal fango treatment of healthy probands and patients with liver disease [5]. In rats the regional hepatic blood flow increased after application of hot peloid paraffin packs on the abdominal wall [6]. It is well known that hepatic blood flow is regulated by the autonomous nerve system. Adrenergic stimulation by norepinephrine decreased the hepatic blood volume in pigs by 35%, vasodilatation increased it by 15% [7]. External heat may reduce the activity of the sympathetic nerve system and therefore increase the hepatic blood volume. Moreover, reflex circuits between the skin and inner organs have been demonstrated in animals and postuPublished: 10 July 2007 BMC Gastroenterology 2007, 7:27 doi:10.1186/1471-230X-7-27 Received: 16 November 2006 Accepted: 10 July 2007 This article is available from: http://www.biomedcentral.com/1471-230X/7/27 © 2007 Huber et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.