Circulating methemoglobin and nitrite/nitrate concentrations as indicators of nitric oxide overproduction in critically ill children with septic shock

Brian Krafte-Jacobs, Richard Brilli, Csaba Szabó, Alvin Denenberg, Lori Moore, Andrew L. Salzman

    Research output: Contribution to journalArticle

    55 Scopus citations

    Abstract

    Objectives: To examine the relationship between circulating methemoglobin and nitrite/nitrate concentrations and to compare these markers of nitric oxide overproduction with clinical variables in children diagnosed with septic shock. Design: Prospective, controlled, clinical study. Setting: Pediatric intensive care unit and outpatient clinic in a children's hospital. Patients: Twenty-two children diagnosed with septic shock and ten age- matched healthy control patients. Interventions: Patients diagnosed with septic shock had blood specimens taken on study entry and every 6 hrs for 72 hrs for methemoglobin and nitrite/nitrate determinations. Single blood specimens were obtained from controls. Measurements and Main Results: Circulating methemoglobin and nitrite/nitrate concentrations were significantly higher in children diagnosed with septic shock in comparison with healthy control children (p = .01 and .05, respectively). Peak nitrite/nitrate concentrations correlated with serum creatinine (r2 = .19; p = .04) and were inversely correlated with arterial PH (r2 =.28; p = .01) and urine output (r2 = .21; p = .03) when analyzed by log-linear regression. There were no significant relationships between methemoglobin and nitrite/nitrate or between methemoglobin and any other clinical variable. Conclusions: Circulating methemoglobin and nitrite/nitrate concentrations are increased in children diagnosed with septic shock. Plasma nitrite/nitrate values correlate with selected clinical variables in these children. Circulating methemoglobin measurements are not superior to plasma nitrite/nitrate concentrations as an indicator of endogenous overproduction of nitric oxide in children diagnosed with septic shock. A need remains to develop markers of endogenous nitric oxide activity that have greater accuracy and reliability.

    Original languageEnglish (US)
    Pages (from-to)1588-1593
    Number of pages6
    JournalCritical care medicine
    Volume25
    Issue number9
    DOIs
    StatePublished - Sep 26 1997

    Keywords

    • Children
    • Critical care
    • Methemoglobin
    • Nitrate
    • Nitric oxide
    • Nitrite
    • Sepsis
    • Septic shock

    ASJC Scopus subject areas

    • Critical Care and Intensive Care Medicine

    Fingerprint Dive into the research topics of 'Circulating methemoglobin and nitrite/nitrate concentrations as indicators of nitric oxide overproduction in critically ill children with septic shock'. Together they form a unique fingerprint.

  • Cite this