Doughty L, Carcillo J A, Kaplan S, Janosky J
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, PA, USA.
Crit Care Med. 1998 Jan;26(1):157-62. doi: 10.1097/00003246-199801000-00032.
To determine whether plasma nitrite and nitrate concentrations are associated with the development of sepsis-induced multiple organ failure.
Prospective study.
University children's hospital.
Fifty-three consecutive children meeting criteria for sepsis and not receiving exogenous sources of nitric oxide.
Plasma nitrite and nitrate concentrations were measured, and the number of organs failing was scored using an organ failure index on the first 3 days of sepsis.
Children with three or more organs failing on day 3 of sepsis had higher plasma nitrite and nitrate concentrations than children who had resolution of failure of three or more organs by day 3 of sepsis (days 2 and 3) and children who never had three organs failing in the first 3 days of sepsis (days 1, 2, and 3). Children who developed sequential pulmonary/hepatic/renal organ failure had significantly higher plasma nitrite and nitrate concentrations (days 1, 2, and 3). Nonsurvivors had significantly higher plasma nitrite and nitrate concentrations (days 2 and 3) than survivors. Plasma nitrite and nitrate concentrations on day 1 predicted the development of persistent failure of three of more organs and sequential multiple organ failure but not mortality.
Increased plasma nitrite and nitrate concentrations are associated with the development of multiple organ failure in pediatric sepsis.
确定血浆亚硝酸盐和硝酸盐浓度是否与脓毒症诱发的多器官功能衰竭的发生有关。
前瞻性研究。
大学儿童医院。
53名符合脓毒症标准且未接受外源性一氧化氮的连续儿童。
测量血浆亚硝酸盐和硝酸盐浓度，并在脓毒症的前3天使用器官衰竭指数对衰竭器官的数量进行评分。
脓毒症第3天有三个或更多器官衰竭的儿童，其血浆亚硝酸盐和硝酸盐浓度高于在脓毒症第3天（第2天和第3天）三个或更多器官功能衰竭已缓解的儿童，以及在脓毒症前3天（第1天、第2天和第3天）从未有过三个器官衰竭的儿童。发生序贯性肺/肝/肾器官衰竭的儿童血浆亚硝酸盐和硝酸盐浓度显著更高（第1天、第2天和第3天）。非幸存者的血浆亚硝酸盐和硝酸盐浓度（第2天和第3天）显著高于幸存者。第1天的血浆亚硝酸盐和硝酸盐浓度可预测三个或更多器官持续衰竭和序贯性多器官衰竭的发生，但不能预测死亡率。
血浆亚硝酸盐和硝酸盐浓度升高与儿童脓毒症中多器官功能衰竭的发生有关。
