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Lee, Kim, Lee, Park, Oh, Sheen, Choi, Park, and Hwang: Correlation of Nitric Oxide and Corticosteroids Along the Course of Sepsis
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(4): 308-313.

Published online: 30 April 2007

DOI: https://doi.org/10.4046/trd.2007.62.4.308

Correlation of Nitric Oxide and Corticosteroids Along the Course of Sepsis

Keu Sung Lee, M.D., Young Sun Kim, M.Sc., Hyoung No Lee, M.D., Joo Hun Park, M.D., Yoon Jung Oh, M.D., Seung Soo Sheen, M.D., Young Hwa Choi, M.D., Kwang Joo Park, M.D., Sung Chul Hwang, M.D.

Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.

Address for correspondence: Kwang Joo Park, M.D. Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, Gyeonggi-do, 443-721, Korea. Phone: 82-31-219-5121, Fax: 82-31-219-5124, parkkj@ajou.ac.kr

Received 29 November 2006       Accepted 22 March 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

The nitric oxide (NO) released by inducible NO synthase (iNOS) plays an important role in the pathophysiology of sepsis. Corticosteroids also play a role in the hemodynamic and inflammatory reactions in sepsis. Both have been shown to have a relationship theoretically, but their correlation and clinical impacts have rarely been evaluated.

Methods

26 patients with sepsis and 14 healthy controls were enrolled in this study. The initial random plasma total NO and the serum cortisol levels were measured. The same measurements were serially carried out on the 3rd, 5th, and 7th days.

Results

The initial total plasma levels of NO and cortisol were higher in the patients with sepsis than in the healthy controls. The total NO levels were higher in patients with severe sepsis than in the those with mild sepsis. There was a correlation between the total NO and cortisol level throughout the study.

Conclusion

In patients with sepsis, the levels of plasma NO and cortisol were well correlated during the first week of sepsis, which suggests an interrelationship. However, the clinical and pathogenetic implications await further evaluation.

Keywords: Sepsis, Septic shock, Nitric oxide, Nitric oxide synthase, Corticosteroids, Cortisol, Correlation

Figures and Tables

Figure 1
Comparison of initial levels of (A) plasma total NO, and (B) serum cortisol between sepsis patients and the controls.
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Figure 2
Comparison of initial levels of plasma NO between patients with severe and mild sepsis.
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Figure 3
Correlations between levels of initial plasma NO and other parameters; (A) serum cortisol levels, (B) serum lactate levels, and (C) APACHE II scores in patients with sepsis.
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Table 1
Serial correlations between NO and cortisol levels in the 1st (D1), 3rd (D3), 5th (D5), and 7th (D7) days in patients with sepsis
trd-62-308-i001

Data are given as median (interquartile range).

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