NITRIC-OXIDE AND THE SURGICAL PATIENT - IDENTIFYING THERAPEUTIC TARGETS

It has been a decade since the elucidation of the key components of L- arginine to the nitric oxide (NO) pathway.(1-3) Knowledge in this fiel d has expanded at a dizzying pace such that it is clear that NO partic ipates in some way in essentially every physiologic process. Just as i mportant has been the characterization of roles of NO in the pathophys iological features of many disease processes. New findings appear in t he scientific literature al a rate that overwhelms even the most dedic ated NO researchers. The universal interest in the biomedical importan ce of this molecule recently became evident with the creation of the N itric Oxide Society along with its peer-reviewed publication, Nitric O xide: Biology and Chemistry, With this tremendous investment of resear ch resources, the clinician cannot help but wonder, ''What have we lea rned that is clinically relevant?'' and ''Where are the therapeutic di vidends?'' This article will provide some of the key observations made about NO relevant to the biological responses of surgical patients an d discuss some of the therapies based on NO research on the horizon. F irst, we will summarize basic NO biochemistry.