Role of active nitrogen molecules in progression of septic shock

• Published in: Acta anaesthesiologica Scandinavica Vol. 56; no. 3; pp. 307 - 315
• Main Authors: KOTHARI, N., BOGRA, J., KOHLI, M., MALIK, A., KOTHARI, D., SRIVASTAVA, S., KESHARI, R.S., SINGH, V., BARTHWAL, M.K., DIKSHIT, M.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01.03.2012; Blackwell
• Subjects: Adult; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; APACHE; Biological and medical sciences; Creatinine - blood; Creatinine - urine; Critical Care; Critical Illness; Disease Progression; Enzyme-Linked Immunosorbent Assay; Female; Humans; Kidney Function Tests; Lactic Acid - blood; Male; Medical sciences; Nitrates - blood; Nitric Oxide - metabolism; Nitrites - blood; Reactive Nitrogen Species - blood; Reactive Nitrogen Species - metabolism; Shock, Septic - blood; Shock, Septic - metabolism; Systemic Inflammatory Response Syndrome - blood; Tumor Necrosis Factor-alpha - metabolism; Vascular Resistance - physiology; Infection; Anesthesia; Septic shock; Nitrogen
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2011.02607.x

Introduction Active nitrogen molecules are formed as a result of cell metabolism. They are essential for cell metabolism, but when produced in excess, they contribute to the pathogenesis of several disease processes. These nitrogen molecules play an important role in vascular instability of septic shock. This study was planned to detect the role of active nitrogen molecules in the progression of septic shock. Materials and methods Blood samples were collected from 118 critically ill patients admitted in ICU and from 95 healthy relatives accompanying the patients. Patients were categorized into three groups: systemic inflammatory response syndrome (n = 54), sepsis (n = 35) and septic shock (n = 29). Plasma total nitrite (nitrites and nitrates), cytokines like tumour necrosis factor‐α (TNF‐α) and plasma lactate were measured to assess inflammatory activity and severity of septic shock. Results High plasma levels of nitrite and nitrate (No2‐/No3‐) were observed in critically ill patients (mean level 78.92 μmol/l in sepsis and 97.20 μmol/l in septic shock). Mean plasma TNF‐α level in sepsis was 213.50 pg/ml and septic shock was 227.38 pg/ml. Conclusion Plasma No2‐/No3‐ and TNF‐α levels were high in patients with sepsis and septic shock, which increased with severity of sepsis.