SERUM LEVELS OF END-PRODUCTS OF NITRIC-OXIDE SYNTHESIS CORRELATE POSITIVELY WITH TUMOR-NECROSIS-FACTOR A AND NEGATIVELY WITH BODY-TEMPERATURE IN PATIENTS WITH POSTOPERATIVE ABDOMINAL SEPSIS

Nitric oxide (NO) has been implicated as the principal mediator of the catecholamine resistant vasodilation in septic shock. In this pilot s tudy, we wanted to know if the serum values of nitrite/nitrate (NO2/NO 3), the stable endproducts of NO biosynthesis, are elevated in patient s with septic shock. Furthermore, we investigated whether there is a c orrelation between NO2/NO3 serum levels and tumor necrosis factor alph a or interleukin 6. NO2/NO3 serum values were significantly elevated i n septic patients compared to controls (72.1 +/- 6.1 vs. 35.7 +/- 9.2 mu M, p <.001). There was a significant positive correlation between s erum values of NO2/NO3 and tumor necrosis factor alpha (r(s) = 0.59, p <.001). In contrast, no correlation between NO2/NO3 and interleukin 6 was found. With the exception of body core temperature, which showed a negative correlation with NO2/NO3 levels, no clinical variable turne d out to be significantly related to NO biosynthesis. These data indic ate a potential role for NO in the clinical course of abdominal sepsis , but points out that more specific data has to be evaluated by prospe ctive clinical studies in order to understand the complex pathophysiol ogic role of this novel mediator.