Intensive Care Medicine

, Volume 33, Issue 6, pp 1094–1101 | Cite as

The effect of iNOS deletion on hepatic gluconeogenesis in hyperdynamic murine septic shock

  • Gerd Albuszies
  • Josef Vogt
  • Ulrich Wachter
  • Christoph Thiemermann
  • Xavier M. Leverve
  • Sandra Weber
  • Michael Georgieff
  • Peter RadermacherEmail author
  • Eberhard Barth



To investigate the role of the inducible nitric oxide synthase activation-induced excess nitric oxide formation on the rate of hepatic glucose production during fully resuscitated murine septic shock.


Prospective, controlled, randomized animal study.


University animal research laboratory.


Male C57Bl/6 and B6.129P2-Nos2tm1Lau/J (iNOS−/−) mice.


Fifteen hours after cecal ligation and puncture, anesthetized, mechanically ventilated and instrumented mice (wild-type controls, n = 13; iNOS−/−, n = 12; wild-type mice receiving 5 mg·kg−1 i.p. of the selective iNOS inhibitor GW274150 immediately after cecal ligation and puncture, n = 8) received continuous i.v. hydroxyethylstarch and norepinephrine to achieve normotensive and hyperdynamic hemodynamics.

Measurements and results

Measurements were recorded 18, 21 and 24 h after cecal ligation and puncture. Liver microcirculatory perfusion and capillary hemoglobin O2 saturation (laser Doppler flowmetry and remission spectrophotometry) were well maintained in all groups. Despite significantly lower norepinephrine doses required to achieve the hemodynamic targets, the rate of hepatic glucose production (gas chromatography–mass spectrometry measurements of tissue isotope enrichment during continuous i.v. 1,2,3,4,5,6-13C6-glucose infusion) at 24 h after cecal ligation and puncture was significantly higher in both iNOS−/− and GW274150-treated mice, which was concomitant with a significantly higher hepatic phosphoenolpyruvate carboxykinase activity (spectrophotometry) in these animals.


In normotensive, hyperdynamic septic shock, both pharmacologic and genetic deletion of the inducible nitric oxide synthase allowed maintenance of hepatic glucose production, most likely due to maintained activity of the key regulatory enzyme of gluconeogenesis, phosphoenolpyruvate carboxykinase.


Laser Doppler flowmetry Remission spectrophotometry Stable isotope Tracer dilution modeling Phosphoenolpyruvate carboxykinase Glucose-6-phosphatase 

Supplementary material


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Gerd Albuszies
    • 1
  • Josef Vogt
    • 1
  • Ulrich Wachter
    • 1
  • Christoph Thiemermann
    • 2
  • Xavier M. Leverve
    • 3
  • Sandra Weber
    • 1
  • Michael Georgieff
    • 1
  • Peter Radermacher
    • 1
    Email author
  • Eberhard Barth
    • 1
  1. 1.Sektion Anästhesiologische Pathophysiologie und VerfahrensentwicklungUniversitätsklinikumUlmGermany
  2. 2.Department of Experimental Medicine and NephrologyThe William Harvey Research InstituteLondonUK
  3. 3.Laboratoire de Bioénergétique Fondamentale et AppliquéeUniversité Joseph FourierGrenobleFrance

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