PLASMA NITRITE AND NITRATE CONCENTRATIONS AND MULTIPLE ORGAN FAILURE IN PEDIATRIC SEPSIS

Objective: To determine whether plasma nitrite and nitrate concentrati ons are associated with the development of sepsis induced multiple org an failure. Design: Prospective study. Setting: University children's hospital. Patients: Fifty three consecutive children meeting criteria for sepsis and not receiving exogenous sources of nitric oxide. Interv entions: Plasma nitrite and nitrate concentrations were measured, and the number of organs failing was scored using an organ failure index o n the first 3 days of sepsis. Measurements and Main Results: Children with three or more organs failing on day 3 of sepsis had higher plasma nitrite and nitrate concentrations than children who had resolution o f failure of three or more organs by day 3 of sepsis (days 2 and 3) an d children who never had three organs failing in the first 3 days of s epsis (days 1, 2, and 3). Children who developed sequential pulmonary/ hepatic/renal organ failure had significantly higher plasma nitrite an d nitrate concentrations (days 1, 2, and 3). Nonsurvivors had signific antly higher plasma nitrite and nitrate concentrations (days 2 and 3) than survivors. Plasma nitrite and nitrate concentrations on day 1 pre dicted the development of persistent failure of three of more organs a nd sequential multiple organ failure but not mortality. Conclusion: In creased plasma nitrite and nitrate concentrations are associated with the development of multiple organ failure in pediatric sepsis.