Relationship between serum nitrite/nitrate levels in the early phase of septic acute lung injury and prognosis

Introduction

Serum nitrite/nitrate (NOx) levels in the early phase of septic acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) have recently been reported to possibly play a key role in pathogenesis of ALI/ARDS.

Methods

NOx levels in the early phase of septic ALI/ARDS were measured by autoanalyzer (TCI-NOX 1000; Tokyo Kasei Kogyo Co., Ltd, Tokyo, Japan). Cytokine was measured by ELISA (Medogenix, Fleurus, Belgium).

Results

Both NOx and TNFα levels were significantly higher in the ARDS group than in the ALI group. A negative correlation was found between the PaO₂/FIO₂ (P/F) ratio and serum NOx levels. In addition, a positive correlation was found between the TNFα and serum NOx levels. The 30-day, 60-day and 90-day mortality rates were 8.7%, 15.2% and 19.6%, respectively, in the patients with ALI/ARDS. There were no differences in the P/F ratio, serum NOx levels or TNFα levels in the early phase of ALI/ARDS between the 30-day survival and death groups. On the other hand, the P/F ratio, serum NOx levels and TNFα levels in the early phase of ALI/ARDS were significantly higher in the 60-day and 90-day death groups than in the corresponding survival groups. There were no significant differences in the 90-day mortality rates between the ALI and ARDS groups.

Conclusion

Our findings suggested that NOx may be involved in the pathogenesis of ALI/ARDS.