Display options
Share it on

Intensive Care Med. 1996 Nov;22(11):1197-202. doi: 10.1007/BF01709336.

Nitric oxide (NO) production correlates with renal insufficiency and multiple organ dysfunction syndrome in severe sepsis.

Intensive care medicine

P H Groeneveld, K M Kwappenberg, J A Langermans, P H Nibbering, L Curtis

Affiliations

  1. Department of Infectious Diseases, University Hospital Leiden, The Netherlands.

PMID: 9120113 DOI: 10.1007/BF01709336

Abstract

OBJECTIVE: To investigate whether the production of nitric oxide (NO) relates to the development of renal insufficiency and multiple organ dysfunction syndrome (MODS) in patients with severe sepsis.

DESIGN: Prospective study in 23 patients with severe sepsis.

SETTING: Medical and surgical intensive care units (ICU) of three hospitals.

MEASUREMENTS AND RESULTS: Serum nitrate levels, as an indirect parameter of the production of NO in vivo, and scores for renal insufficiency and MODS were determined in patients with severe sepsis during a 1-week period after admission to the ICU. The highest serum nitrate levels were found at 4 h (mean 52 +/- 16 mumol/l) after entry into the study and the levels gradually declined thereafter. Patients with renal insufficiency had considerably higher serum nitrate levels during the study period that patients who did not develop renal sufficiency (MANOVA, p < 0.05). Serum nitrate levels correlated with scores for renal insufficiency (r = 0.60, p < 0.001), and far exceeded the levels that can be explained solely by reduced renal clearance of nitrate. Further analysis showed that serum nitrate levels significantly and positively correlated with scores for MODS (r = 0.44, p < 0.001).

CONCLUSION: Our results indicate that the production of NO correlates with renal insufficiency and MODS in patients with severe sepsis and that this reactive nitrogen intermediate could be involved in the pathogenesis of organ failure in these critically ill patients.

References

  1. N Engl J Med. 1993 May 20;328(20):1471-7 - PubMed
  2. Proc Natl Acad Sci U S A. 1991 Jul 15;88(14):6338-42 - PubMed
  3. Cell. 1995 May 19;81(4):641-50 - PubMed
  4. J Lab Clin Med. 1994 Oct;124(4):478-83 - PubMed
  5. Br J Pharmacol. 1992 Jan;105(1):11-2 - PubMed
  6. Am J Physiol. 1994 Jun;266(6 Pt 1):E829-39 - PubMed
  7. J Exp Med. 1992 Oct 1;176(4):1175-82 - PubMed
  8. Proc Natl Acad Sci U S A. 1990 Jul;87(13):5193-7 - PubMed
  9. Lancet. 1994 Jun 18;343(8912):1579-80 - PubMed
  10. J Clin Invest. 1992 Nov;90(5):1718-25 - PubMed
  11. J Surg Res. 1994 Jul;57(1):93-8 - PubMed
  12. Proc Natl Acad Sci U S A. 1994 Mar 1;91(5):1691-5 - PubMed
  13. Circ Shock. 1993 Oct;41(2):77-81 - PubMed
  14. Br J Pharmacol. 1990 Dec;101(4):815-20 - PubMed
  15. J Trauma. 1993 Oct;35(4):590-6; discussion 596-7 - PubMed
  16. Ann Intern Med. 1994 May 1;120(9):771-83 - PubMed
  17. Circ Res. 1993 Jul;73(1):164-71 - PubMed
  18. Science. 1987 Jan 23;235(4787):473-6 - PubMed
  19. J Clin Invest. 1992 Mar;89(3):867-77 - PubMed
  20. Crit Care Med. 1995 Feb;23(2):253-8 - PubMed
  21. Lancet. 1991 Dec 21-28;338(8782-8783):1555-7 - PubMed
  22. FASEB J. 1992 Sep;6(12):3051-64 - PubMed
  23. N Engl J Med. 1993 Dec 30;329(27):2002-12 - PubMed
  24. J Surg Res. 1994 Jun;56(6):524-9 - PubMed
  25. Chest. 1992 Jun;101(6):1644-55 - PubMed
  26. Scand J Infect Dis. 1995;27(5):453-6 - PubMed
  27. J Cell Physiol. 1992 Jun;151(3):506-11 - PubMed
  28. Crit Care Med. 1995 May;23(5):835-42 - PubMed
  29. N Engl J Med. 1994 Jun 2;330(22):1620 - PubMed
  30. Proc Natl Acad Sci U S A. 1991 Jun 1;88(11):4651-5 - PubMed
  31. Crit Care Med. 1994 Mar;22(3):465-9 - PubMed
  32. Crit Care Med. 1993 Sep;21(9):1287-95 - PubMed
  33. Arch Surg. 1994 Feb;129(2):142-7; discussion 147-8 - PubMed
  34. Crit Care Med. 1992 Nov;20(11):1568-74 - PubMed
  35. Surgery. 1986 Feb;99(2):140-53 - PubMed
  36. Ann Surg. 1991 Nov;214(5):621-6 - PubMed
  37. Cancer Res. 1983 Apr;43(4):1921-5 - PubMed
  38. Am J Physiol. 1994 Apr;266(4 Pt 2):H1558-64 - PubMed

Substances

MeSH terms

Publication Types