title: Role of active nitrogen molecules in progression of septic shock.
abstract: BACKGROUND
  Active nitrogen molecules are formed as a result of cell metabolism. They are essential for cell metabolism, but when produced in excess, they contribute to the pathogenesis of several disease processes. These nitrogen molecules play an important role in vascular instability of septic shock. This study was planned to detect the role of active nitrogen molecules in the progression of septic shock.
  
  
  METHODS
  Blood samples were collected from 118 critically ill patients admitted in ICU and from 95 healthy relatives accompanying the patients. Patients were categorized into three groups: systemic inflammatory response syndrome (n = 54), sepsis (n = 35) and septic shock (n = 29). Plasma total nitrite (nitrites and nitrates), cytokines like tumour necrosis factor-α (TNF-α) and plasma lactate were measured to assess inflammatory activity and severity of septic shock.
  
  
  RESULTS
  High plasma levels of nitrite and nitrate (No₂-/No₃-) were observed in critically ill patients (mean level 78.92 μmol/l in sepsis and 97.20 μmol/l in septic shock). Mean plasma TNF-α level in sepsis was 213.50 pg/ml and septic shock was 227.38 pg/ml.
  
  
  CONCLUSIONS
  Plasma No₂-/No₃- and TNF-α levels were high in patients with sepsis and septic shock, which increased with severity of sepsis.
authors.affiliation: Department of Anaesthesia, CSM Medical University, Lucknow, India. madhu_dikshit@cdri.res.in
authors.forename: N
authors.initials: N
authors.lastname: Kothari
authors.forename: J
authors.initials: J
authors.lastname: Bogra
authors.forename: M
authors.initials: M
authors.lastname: Kohli
authors.forename: A
authors.initials: A
authors.lastname: Malik
authors.forename: D
authors.initials: D
authors.lastname: Kothari
authors.forename: S
authors.initials: S
authors.lastname: Srivastava
authors.forename: R S
authors.initials: RS
authors.lastname: Keshari
authors.forename: V
authors.initials: V
authors.lastname: Singh
authors.forename: M K
authors.initials: MK
authors.lastname: Barthwal
authors.forename: M
authors.initials: M
authors.lastname: Dikshit
mesh_terms: D018806:APACHE; D000328:Adult; D003404:Creatinine / Q000097:blood / Q000652:urine; D003422:Critical Care; D016638:Critical Illness; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D019344:Lactic Acid / Q000097:blood; D008297:Male; D009566:Nitrates / Q000097:blood; D009569:Nitric Oxide / Q000378:metabolism; D009573:Nitrites / Q000097:blood; D026361:Reactive Nitrogen Species / Q000097:blood / Q000378:metabolism*; D012772:Shock, Septic / Q000097:blood / Q000378:metabolism*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014655:Vascular Resistance / Q000502:physiology
chemical_list: D009566:Nitrates; D009573:Nitrites; D026361:Reactive Nitrogen Species; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D019344:Lactic Acid; D003404:Creatinine