Nitric oxide and active oxygen species in severe sepsis and surgically stressed patients

To clarify how the kinetics of nitric oxide (NO) and active oxygen species are correlated with the occurrence of organ dysfunction in sepsis, the levels of monocyte-associated NO₂, NO₃, and active oxygen species were examined in severely septic patients with multiple organ dysfunction syndrome (group M; n=5), and the results compared with those of postoperative patients who had undergone gastrointestinal surgery (group S; n=5) and healthy volunteers (group C; n=10). The production of NO₂ and NO₃ by monocytes was significantly higher in group M than in the other two groups, while the production of active oxygen species by monocytes was significantly higher in groups M and S, than in group C. A significant correlation between the production of NO₂ and that of active oxygen species by monocytes was noted only in group M. These findings indicate that the simultaneous activation of NO and active oxygen species production by monocytes is a prerequisite for the onset of multiple organ dysfunction in severe sepsis.This paper was originally presented at the 22nd meeting of the Japanese Society for Abdominal Emergency Medicine held in Takarazuka in 1994.