Serum nitric oxide and pediatric sepsis outcomes
Abstract
Background Sepsis is the complex pathophysiologic responses
of the host against systemic infection. Sepsis can cause severe
conditions such as septic shock and multiple organ failure.
Although we have a better understanding of the molecular basis
of sepsis as well as aggressive therapy, the mortality rate remains
high, between 20-80%. Nitric oxide (NO) is one of the mediators
associated with cardiovascular failure, apoptosis and organ
dysfunction in sepsis.
Objective To evaluate for a possible correlation between NO
levels and outcomes in pediatric sepsis.
Methods A prospective cohort study was conducted at the
pediatric intensive care unit (PICU) of Prof. Dr. R.D. Kandou
General Hospital in Manado, from June to November 2012. Forty
children aged one month to five year old, fulfilled the International
Pediatrics Sepsis Consensus Conference 2 005 criteria were recruited.
Nitrite oxide metabolites (nitrite and nitrate) levels were measured
using a calorimetric assay kit (Cayman®, Catalog No.780001)
from venous blood specimens collected at admission. All patients
received antibiotics empirically within an hour of the diagnosis.
Outcomes of patients recorded were survivor or died, and length
of stay in PICU.
Results Mann-Whitney U test revealed a significant difference
between median serum NO levels ins urvivors and those who died
(18.60 vs. 36.50 fLM/L, respectively; P= 0.016).
Conclusion Serum NO concentration is higher in those who
died than in survivors of pediatric sepsis. Specific NO inhibition
may be beneficial in decreasing morbidity and mortality in this
condition.
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Accepted 2016-09-16
Published 2014-08-31
