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The Role of the L-Arginine Nitric Oxide Pathway in Sepsis and Endotoxaemia with Special Reference to Vascular Impairment

  • Chapter
Pathophysiology of Shock, Sepsis, and Organ Failure

Abstract

“Unresponsive hypotension” is a major contributory factor in the multiple organ failure associated with sepsis (Parrillo 1989) and many patients in septic shock die as a result of peripheral vascular failure (Siegel et al. 1967; Parker et al. 1984; Pollack et al. 1984; Groeneveld et al. 1986; Thijs et al. 1987). For example, a persistent vasodilatation and a high cardiac index were found in 57% of nonsurvivors in the study of Groeneveld et al. (1986). This persistent loss of vascular tone has been attributed to paralysis (plegia) of vascular smooth muscle and this unrelenting ‘hypotension’ is refractory to vasoconstrictor doses of catecholamines.

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  1. I. Fleming

    Present address: Institute for Applied Physiology, Hermann-Herder-Strasse 7, 7800, Freiburg, Germany

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  1. Department of Physiology and Pharmacology, University of Strathclyde, Glasgow, Gl 1XW, Scotland, UK

    J. R. Parratt

  2. Laboratoire de Cellulaire et Moléculaire, Faculté de Pharmacie, Université Louis Pasteur, Strasbourg, France

    J.-C. Stoclet

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  1. Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, A-1200, Vienna, Austria

    Günther Schlag M. D.  & Heinz Redl Ph. D.  & 

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Parratt, J.R., Stoclet, JC., Fleming, I. (1993). The Role of the L-Arginine Nitric Oxide Pathway in Sepsis and Endotoxaemia with Special Reference to Vascular Impairment. In: Schlag, G., Redl, H. (eds) Pathophysiology of Shock, Sepsis, and Organ Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76736-4_42

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