Increased endogenous carbon monoxide production in severe sepsis.
OBJECTIVE
A comparison was made between the endogenous carbon monoxide (CO) production in mechanically ventilated critically ill adult patients with, and those without, severe sepsis.


METHODS
Prospective comparative study.


METHODS
Medical ICU in a community hospital.


METHODS
Twenty-four patients with severe sepsis of various etiologies and five control patients with varying diagnoses.


METHODS
CO concentration was determined with an infrared CO analyzer on exhaled breath collected at the outlet of the ventilator. Endogenous CO production was estimated by the lung CO excretion rate measured at steady state.


RESULTS
: Endogenous CO production was higher in the sepsis group during the first 3 days of treatment in comparison to the control group (10.9+/-5 (SD) microl/kg per h on day 1, 7.8+/-4.9 microl/kg per h on day 2 and 6.9+/-4.7 microl/kg per h on day 3 versus 2.1+/-0.5 microl/kg per h; p<0.01 for each comparison). Survivors of sepsis had a significantly higher endogenous CO production on day 1 compared to non-survivors (14.7+/-5.3 versus 8.5+/-3.3 microl/kg per h; p=0.02).


CONCLUSIONS
Endogenous CO production was significantly higher in mechanically ventilated patients suffering from severe sepsis. Further studies are required in order to determine the mechanism(s) and the functional significance of this increase.
Zegdi
Rachid
R
Department of Intensive Care, Louise Michel Hospital, Coucouronnes, France. rzegdi@hotmail.com
Perrin
Dominique
D
Burdin
Michèle
M
Boiteau
Richard
R
Tenaillon
Alain
A
D018806:APACHE; D000368:Aged; D000704:Analysis of Variance; D001944:Breath Tests; D002248:Carbon Monoxide / Q000378:metabolism*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D018384:Oxidative Stress; D011446:Prospective Studies; D018805:Sepsis / Q000145:classification / Q000378:metabolism* / Q000401:mortality
D002248:Carbon Monoxide