Activation of the L-arginine nitric oxide pathway in severe sepsis
a Royal Children's Hospital, Melbourne, Australia:
Paediatric Intensive Care Unit, b Department of
General Paediatrics, c Bernard O'Brien
Institute, St Vincent's Hospital, Melbourne, Australia
Correspondence to: Dr Trevor Duke, Paediatric Intensive Care Unit, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
Accepted 6
September 1996
AIMS
To determine in children with sepsis
syndrome and septic shock the time course of nitric oxide metabolites:
nitrate and nitrite (nitrogen oxides). To determine whether serum
concentrations of nitrogen oxides distinguished those children who died
from sepsis from those who survived; those who required prolonged
inotropic support compared with those who did not; and whether there
was any relationship of the levels of nitrogen oxides to markers of tissue perfusion.
METHODSNitrogen oxides were measured in 30 children with sepsis syndrome or septic shock at admission, 12, 24, and
48 hours. A non-septic control group had serum nitrogen oxides measured
at admission. Markers of haemodynamics and tissue perfusion measured
were mean arterial pressure, blood lactate, base deficit, gastric
intramucosal pH, and deltaCO2 (DCO2: the
difference between arterial and gastric intraluminal carbon dioxide
tensions). Inotrope doses, number of organ systems failing at 48 hours,
and outcome as survival were recorded.
RESULTSChildren with sepsis had increased
nitrogen oxide concentrations at presentation compared with a group of
non-septic controls. Children with organ failure at 48 hours had higher
serum nitrogen oxide concentrations than those with sepsis
uncomplicated by organ failure at 48 hours. There was no difference in
nitrogen oxide when patients were subgrouped according to the receipt
of inotropes at 48 hours, and no association with markers of tissue
perfusion, or survival.
CONCLUSIONSWhile this study shows that nitric
oxide production is increased in sepsis in children, there was a
limited relationship with clinically important markers of illness
severity and no relationship to survival.
|
Key messages
|
© 1997 by Archives of Disease in Childhood
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Baines, P. B., Hart, C. A.
(2003). Severe meningococcal disease in childhood. Br J Anaesth
90: 72-83
[Abstract] [Full Text] -
Aikio, O., Vuopala, K., Pokela, M.-L., Hallman, M.
(2000). Diminished Inducible Nitric Oxide Synthase Expression in Fulminant Early-Onset Neonatal Pneumonia. Pediatrics
105: 1013-1019
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
