Document Detail


Artery-to-vein differences in nitric oxide metabolites are diminished in sepsis.
MedLine Citation:
PMID:  20081526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Nitric oxide deficiency may contribute to microvascular dysfunction in sepsis. Current physiologic paradigms contend that nitrite and/or S-nitrosohemoglobin mediate intravascular delivery of nitric oxide. These nitric oxide metabolites are purportedly consumed during hemoglobin deoxygenation, producing nitric oxide and coupling intravascular nitric oxide delivery with metabolic demand. Systemic nitrite and S-nitrosohemoglobin consumption can be assessed by comparing their concentrations in arterial vs. venous blood. We hypothesized that arterial vs. venous differences in nitrite and S-nitrosohemoglobin are diminished in sepsis and associated with mortality.
DESIGN: Case-control and prospective cohort study.
SETTING: Adult intensive care units of an academic medical center.
PATIENTS AND SUBJECTS: Eighty-seven critically ill septic patients and 52 control subjects.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Nitrite and S-nitrosohemoglobin were measured using tri-iodide-based reductive chemiluminescence. In control subjects, arterial plasma, whole blood, and red blood cell nitrite levels were higher than the corresponding venous levels. In contrast, S-nitrosohemoglobin was higher in venous compared to arterial blood. In septic patients, arterial vs. venous red blood cell nitrite and S-nitrosohemoglobin differences were absent. Furthermore, the plasma nitrite arterial vs. venous difference was absent in nonsurvivors.
CONCLUSIONS: In health, nitrite levels are higher in arterial vs. venous blood (suggesting systemic nitrite consumption), whereas S-nitrosohemoglobin levels are higher in venous vs. arterial blood (suggesting systemic S-nitrosohemoglobin production). These arterial vs. venous differences are diminished in sepsis, and diminished arterial vs. venous plasma nitrite differences are associated with mortality. These data suggest pathologic disruption of systemic nitrite utilization in sepsis.
Authors:
Mary Anne M Morgan; Lauren M Frasier; Judith C Stewart; Cynthia M Mack; Michael S Gough; Brian T Graves; Michael J Apostolakos; Kathleen P Doolin; Denise C Darling; Mark W Frampton; Anthony P Pietropaoli
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-04-09     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1069-77     Citation Subset:  AIM; IM    
Affiliation:
Departments of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Arteries / metabolism*,  physiopathology
Case-Control Studies
Cohort Studies
Female
Hemoglobins / analysis
Hospital Mortality
Humans
Luminescent Measurements
Male
Middle Aged
Nitric Oxide / blood,  metabolism*
Nitrites / blood
Prospective Studies
Sepsis / blood*,  mortality,  physiopathology
Veins / metabolism*,  physiopathology
Grant Support
ID/Acronym/Agency:
K23 HL080077-05/HL/NHLBI NIH HHS; K23 HL80077/HL/NHLBI NIH HHS; UL1 RR 024160/RR/NCRR NIH HHS; UL1 RR024160/RR/NCRR NIH HHS; UL1 RR024160-05/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/Nitrites; 0/S-nitrosohemoglobin; 10102-43-9/Nitric Oxide
Comments/Corrections
Comment In:
Crit Care Med. 2010 Apr;38(4):1214-5   [PMID:  20335702 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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