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Sepsis and Nitric Oxide

  • Chapter
Oxygen Transport to Tissue XVII

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 388))

Abstract

Sepsis or the septic syndrome is the number one cause of mortality in todays intensive care. Overall mortality of sepsis is estimated to be 40 to 60% and when shock or organ failure is present mortality rate is even higher despite recent progress in antibiotic and vasopressor therapy (Bone et al. 1991). The initial cardiovascular changes during hyperdynamic sepsis are characterized by massive vasodilatation with normal to high cardiac output, low peripheral vascular resistance and severe hypotension (Astiz et al. 1987, Groeneveld et al. 1985). In a large number of patients the hypotension is unresponsive to treatment with fluid substitution or vasopressors. This causes hypotension to remain present leading to higher mortality rates. Unresponsive hypotension is present in 50% of patients that die of septic shock (Parker et al. 1987). In the first week, unresponsive hypotension is the primary cause of mortality of septic patients. In a recent retrospective study with one hundred intensive care patients with sepsis, 80% of mortality in the first week was caused by severe hypotension (Ruokonen et al. 1991). For mortality in the second week multiple organ failure (MOF) was the primary cause.

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Authors and Affiliations

  1. Department of Surgery, University Hospital Rotterdam Dijkzigt, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands

    J. A. M. Avontuur & H. A. Bruining

  2. Department of Anaesthesiology, Academic Medical Center University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    C. Ince

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  1. J. A. M. Avontuur
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  2. H. A. Bruining
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  3. C. Ince
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Editors and Affiliations

  1. Academic Medical Center, Amsterdam, The Netherlands

    C. Ince  & J. Kesecioglu  & 

  2. University of Istanbul, Istanbul, Turkey

    L. Telci  & K. Akpir  & 

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© 1996 Plenum Press, New York

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Avontuur, J.A.M., Bruining, H.A., Ince, C. (1996). Sepsis and Nitric Oxide. In: Ince, C., Kesecioglu, J., Telci, L., Akpir, K. (eds) Oxygen Transport to Tissue XVII. Advances in Experimental Medicine and Biology, vol 388. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0333-6_71

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  • DOI: https://doi.org/10.1007/978-1-4613-0333-6_71

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-8002-3

  • Online ISBN: 978-1-4613-0333-6

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