ISSN:
1432-1238
Keywords:
Key words Sepsis
;
Nitric oxide
;
Nitric oxide synthase inhibition
;
l-NAME
;
Cytokines
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objectives: We tested the effects of NG-nitro-l-arginine methyl ester (l-NAME), an inhibitor of nitric oxide (NO) synthesis, on plasma levels of interleukin (IL) IL-6, IL-8, tumor necrosis factor-alpha (TNFα) and nitrite/nitrate (NO2 −/NO3 −) in patients with severe septic shock. Design: Prospective clinical study. Setting: Surgical intensive care unit at a university hospital. Patients: 11 consecutive patients with severe septic shock. Interventions: Standard hemodynamic measurements were made and blood samples taken at intervals before, during, and after a 12-h infusion of l-NAME 1 mg ·kg−1·h−1 for determination of plasma IL-6, IL-8, TNFα and NO2 −/NO3 − concentration. Measurements and results: Patients with sepsis had increased plasma levels of IL-6, IL-8, TNFα, and NO2 −/NO3 − (p 〈 0.05). Plasma levels of IL-6, IL-8, and NO2 −/NO3 − were negatively correlated with systemic vascular resistance (r = −0.62, r = −0.65, and r = −0.78, respectively, all p 〈 0.05). Continuous infusion of l-NAME increased mean arterial pressure and systemic vascular resistance, with a concomitant reduction in cardiac output (all p 〈 0.01). No significant changes were seen in levels of plasma IL-6, IL-8, and NO2 −/NO3 − during the 24-h observation period. Plasma levels of TNFα were significantly reduced during l-NAME infusion compared to baseline (p 〈 0.05). Conclusions: NO plays a role in the cardiovascular derangements of human septic shock. Inhibition of NO synthesis with l-NAME does not promote excessive cytokine release in patients with severe sepsis.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001340050643
Permalink