NITRIC-OXIDE PRODUCTION IS INHIBITED IN TRAUMA PATIENTS

Elevated levels of nitrates/nitrites, the stable endproducts of nitric oxide (NO), were recently observed in septic patients. In this settin g, NO maintains blood flow by vasodilation and inhibition of platelet aggregation. Trauma patients were found to have low plasma levels of n itrates/nitrites, even when they developed sepsis. The current study s ubstantiated that trauma patients have suppressed production of NO; re ductions in plasma nitrate/nitrite levels correlated with low urinary excretion of these endproducts. Nitric oxide production was upregulate d in trauma patients with clinical infection compared with trauma pati ents without infection, but was still significantly suppressed compare d with nitric oxide production in normal controls. The inability of tr auma patients to produce NO may be an important component of the susce ptibility of these patients to infection.