| Nitric oxide synthase inhibition by L-NAME in leukocytopenic patients with severe septic shock. | |
| | |
MedLine Citation:
|
PMID: 9201529 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To investigate the effects of nitric oxide synthase inhibition by NG-nitro-L-arginine methyl ester (L-NAME) on hemodynamics and outcome in leukocytopenic (< 1000/microliter) patients with severe septic shock requiring strong vasopressor support. DESIGN: Prospective clinical study. SETTING: Medical intensive care unit. PATIENTS: 10 patients with hematologic malignancies in chemotherapy-induced leukocytopenia with severe septic shock and high-dose vasopressor requirement. INTERVENTION: Continuous intravenous infusion of L-NAME (0.3 mg/ kg per hour) for a study period of 24 h with prolongation for up to 96 h according to individual requirements. MEASUREMENTS AND RESULTS: Compared to baseline values, an increase in mean arterial pressure (p = 0.0021), systemic vascular resistance (p = 0.0001), and left ventricular stroke work index (p = 0.023) with a concomitant decrease in vasopressor requirement (p < 0.05) was observed during the first 24 h of L-NAME treatment. Cardiac output data were unchanged during the study period (p = 0.49). L-NAME was tapered off in five patients who again became responsive to vasopressor medication. Two patients survived the episode of septic shock and vasoactive medication was stopped. CONCLUSIONS: The data demonstrate that inhibition of nitric oxide synthase may be beneficial for the treatment of severe septic shock in leukocytopenic patients as indicated by an increase in systemic vascular resistance, mean arterial pressure, and left ventricular stroke work index. |
| | |
Authors:
|
M G Kiehl; H Ostermann; J Meyer; J Kienast |
Related Documents
:
|
9689279 - Elevated methemoglobin in patients with sepsis. 1951579 - Pudendal neuralgia. 3399069 - Central pontine myelinolysis in severely burned patients: relationship to serum hyperos... 15249459 - Septic shock of early or late onset: does it matter? 18030179 - Polymyxin b-immobilized fiber hemoperfusion with the pmx-05r column in elderly patients... 3250719 - Patient-controlled analgesia for burn patients: a preliminary report. 20015799 - Clinicopathologic similarities between mikulicz disease and küttner tumor. 2821089 - Ct features of hemorrhagic malignant liver tumors. 3889129 - Long-term follow-up of nonvascularized fibular autografts for distal radial reconstruct... |
Publication Detail:
|
Type: Clinical Trial; Journal Article |
Journal Detail:
|
Title: Intensive care medicine Volume: 23 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 1997 May |
Date Detail:
|
Created Date: 1997-08-15 Completed Date: 1997-08-15 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 561-6 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine, University of Muenster, Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Analysis of Variance Antineoplastic Agents / adverse effects Blood Pressure / drug effects Enzyme Inhibitors / therapeutic use* Female Heart Ventricles / drug effects Hematologic Neoplasms / complications, drug therapy Hemodynamics / drug effects* Humans Leukopenia / chemically induced, complications* Male Middle Aged NG-Nitroarginine Methyl Ester / therapeutic use* Nitric Oxide Synthase / antagonists & inhibitors* Prospective Studies Shock, Septic / drug therapy*, etiology Stroke Volume / drug effects Treatment Outcome Vascular Resistance / drug effects Vasoconstrictor Agents / therapeutic use |
| Chemical | |
Reg. No./Substance:
|
0/Antineoplastic Agents; 0/Enzyme Inhibitors; 0/Vasoconstrictor Agents; 50903-99-6/NG-Nitroarginine Methyl Ester; EC 1.14.13.39/Nitric Oxide Synthase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Left ventricular systolic and diastolic function in septic shock.
Next Document: Does continuous heparinization influence platelet function in the intensive care patient?