Nitric oxide and human thermal injury short term outcome.
Nitric oxide (NO) is an important mediator in numerous physiological and pathophysiological events. After thermal injury an increase in plasma and urinary levels has been observed. The real importance of this fact is unknown. The stable NO derivatives (NO2-/NO3-) plasma concentrations were determined in 27 burned patients admitted to the Burn Unit at Santa Maria Hospital in Lisbon at first, third, fifth, seventh, ninth and 15th days and the values were compared with healthy controls (n=9). A significant increase (P<0.05) in burn patient determinations upon admission was found. The patients with inhalation injury revealed greater values compared to the other patients with statistical significance at 5th day (P<0.05). The patients who died showed a NO increase (0.397+/-0.138 vs. 0.267+/-0.017, P> 0.1, day 1) with significance at day 5 (0.615+/-0.223 vs. 0.154+/-0.048, P<0.05). The determinations in patients with sepsis were higher than in the other patients (P<0.01) at day 3. No relation with total burned surface area (TBSA) was found. For the first time, considering burned patients, a significant increase of NO was found in patients who died, in patients with inhalation injury and in patients in sepsis. The possible role of NO in burn injury is discussed. The authors suggest the possible role of NO determination as an indicator of sepsis. The role of NO synthesis inhibitors is discussed. Further studies are needed to clarify these questions.
Department of Pharmacology, Faculdade de Medicina de Lisboa, Hospital de Santa Maria, Lisbon, Portugal. caneira@esoterica.pt
M
M
do Rosário Caneira da Silva
H
H
Mota Filipe
R M
RM
Pinto
Salaverría Timóteo de Carval
M M
MM
Godinho de Matos
A
A
Cordeiro Ferreira
J M
JM
Toscano Rico
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009566:Nitrates / Q000097:blood; D009569:Nitric Oxide / Q000097:blood*; D009573:Nitrites / Q000097:blood; D011379:Prognosis; D015599:Trauma Severity Indices
D015415:Biomarkers; D009566:Nitrates; D009573:Nitrites; D009569:Nitric Oxide