- Poster presentation
- Open Access
Lung nitroxidative stress as a prognostic factor in ventilated septic patients
Critical Care volume 11, Article number: P453 (2007)
During sepsis and mechanical ventilation, nitric oxide (•NO) is produced by lung cells. We study whether pulmonary •NO production is a prognostic factor in mechanically ventilated septic patients.
Materials and methods
We studied 50 patients with sepsis within the first 48 hours of sepsis. Operating room patients served as control a group (ORCG). Nitrite and nitrate (NOx-) and 3-nitrotyrosine (3NT) in plasma and bronchoalveolar lavage fluid (BALF) were analyzed by the Griess/vanadium chloride method and ELISA, respectively. Results were expressed as median and interquartile range. Receiver operator curves were constructed to compare the predictive value of NOx- values in BALF at admission with other variables. Kaplan–Meier analysis was used to compare survival between high and low BALF NOx- levels at admission. A P value less than 0.05 was considered significant.
At study admission in the sepsis group, nonsurvivors had higher levels of BALF NOx- than survivors: 20 (17–33) μM, 27 versus 72 (46–91) μM, 23, P = 0.0001. At day 7, BALF 3NT was higher in nonsurvivor septic patients than in survivors: 1,666 (30–3,173) pmol/mg protein versus 291 (13–1,908) pmol/mg protein. BALF NOx- had the highest area under the receiver operator curve for mortality (0.812, P = 0.001) in relation to other variables. Septic patients with BALF NOx- above 36 μM had a relative risk for mortality of 4.23 and an OR of 15.84. The difference between the low bronchoalveolar •NO group (BALF [NOx-] < 36 μM at admission) versus the high bronchoalveolar •NO group (BALF [NOx-] ≥36 μM at admission) in ICU mortality was significant: 19% versus 78% (log rank 18.19, P = 0.00001).
During sepsis there is enhanced lung •NO production that is associated with ICU mortality.
About this article
Cite this article
Gorrasi, J., Botti, H., Batthyany, C. et al. Lung nitroxidative stress as a prognostic factor in ventilated septic patients. Crit Care 11, P453 (2007). https://0-doi-org.brum.beds.ac.uk/10.1186/cc5613
- Nitric Oxide
- Prognostic Factor
- Bronchoalveolar Lavage
- Septic Patient