Reviewer's report 
 Effects of abdominal hot compresses on indocyanine green elimination - a randomized cross over Title: 
study in healthy subjects 
 3  7 March 2007 Version: Date: 
 Daniel De Backer Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The authors have addressed many of the comments but I have some points left: 
1/ In their answer to reveiwers’ comments, the authors answered positively to my question whether changes 
in ICG PDR may be detected when already normal at baseline. However, this was not implemented in the 
manuscript, as the text mentions that circadian fluctuations may exist and that drugs may affect it, but the direction of the changes is not specified and one may expect that it can only be altered but not further increased. Your sentence should clearly state that it can further increase (what you may expect if the 
intervention increases blood flow). 
2/ The fact that liver enzymes are normal does not rule out that function and flow may evolve in opposite 
way. Please remind that ICG pdr is affected in patients with sepsis well before enzymes become altered. 
3/ You now mention that heat compress application was accompanied by a feeling of relaxation so that all 
patients felt asleep. This may markedly affect PDR. Indeed, splanchnic blood flow decreases during sleep, so that you may expect PDR to decrease (unless there are opposite changes in function, but as function 
was normal at baseline it can no more increase). Hence the stability in ICG PDR along with changes in 
arousal may suggest that splanchnic blood flow was indeed increased by application of compress. This 
needs to be discussed 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests' below 
Reviewer's report 
 Effects of abdominal hot compresses on indocyanine green elimination - a randomized cross over Title: 
study in healthy subjects 
 3  7 March 2007 Version: Date: 
 Daniel De Backer Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The authors have addressed many of the comments but I have some points left: 
1/ In their answer to reveiwers’ comments, the authors answered positively to my question whether changes 
in ICG PDR may be detected when already normal at baseline. However, this was not implemented in the 
manuscript, as the text mentions that circadian fluctuations may exist and that drugs may affect it, but the direction of the changes is not specified and one may expect that it can only be altered but not further increased. Your sentence should clearly state that it can further increase (what you may expect if the 
intervention increases blood flow). 
2/ The fact that liver enzymes are normal does not rule out that function and flow may evolve in opposite 
way. Please remind that ICG pdr is affected in patients with sepsis well before enzymes become altered. 
3/ You now mention that heat compress application was accompanied by a feeling of relaxation so that all 
patients felt asleep. This may markedly affect PDR. Indeed, splanchnic blood flow decreases during sleep, so that you may expect PDR to decrease (unless there are opposite changes in function, but as function 
was normal at baseline it can no more increase). Hence the stability in ICG PDR along with changes in 
arousal may suggest that splanchnic blood flow was indeed increased by application of compress. This 
needs to be discussed 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests' below 
Please review this paper.
user
Reviewer's report 
 Effects of abdominal hot compresses on indocyanine green elimination - a randomized cross over Title: 
study in healthy subjects 
 3  7 March 2007 Version: Date: 
 Daniel De Backer Reviewer: 
Reviewer's report: 
General 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The authors have addressed many of the comments but I have some points left: 
1/ In their answer to reveiwers’ comments, the authors answered positively to my question whether changes 
in ICG PDR may be detected when already normal at baseline. However, this was not implemented in the 
manuscript, as the text mentions that circadian fluctuations may exist and that drugs may affect it, but the direction of the changes is not specified and one may expect that it can only be altered but not further increased. Your sentence should clearly state that it can further increase (what you may expect if the 
intervention increases blood flow). 
2/ The fact that liver enzymes are normal does not rule out that function and flow may evolve in opposite 
way. Please remind that ICG pdr is affected in patients with sepsis well before enzymes become altered. 
3/ You now mention that heat compress application was accompanied by a feeling of relaxation so that all 
patients felt asleep. This may markedly affect PDR. Indeed, splanchnic blood flow decreases during sleep, so that you may expect PDR to decrease (unless there are opposite changes in function, but as function 
was normal at baseline it can no more increase). Hence the stability in ICG PDR along with changes in 
arousal may suggest that splanchnic blood flow was indeed increased by application of compress. This 
needs to be discussed 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Accept after minor essential revisions What next?: 
 An article whose findings are important to those with closely related research interests Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
'I declare that I have no competing interests' below 
assistant