Splanchnic Circulation, Oxygen Budget and Their Correlation with the Content of Nitric Oxide in Sepsis in Children

V.A. Korsunov


Objective. To monitor nitric oxide (NO) production in pediatric sepsis. To define the relationship between the level of serum NO and oxygen transport and consumption and splanichnic circulation.
Material and Methods. The study included 36 children with sepsis, severe sepsis and septic shock. The diagnosis was made according to SCCM/ESICM/ACCP/ATS/SIS criteria (2001). The age of patients was 41.3 ± 7.5 months. We have monitored heart rate, mean arterial pressure, central venous pressure, SaO2, carried out echocardioscopy, pulse wave Doppler ultrasound of the blood flow in main arteries and veins of splanichnic zone. We have determined indicators of acid-base balance, arterial and central venous blood gases, levels of glucose, ­C-reactive protein, serum NO.
Patients were divided into groups: with oxygen consumption of less than 120 ml/min/m2 (group A — 19 patients), and with oxygen consumption over 120 ml/min/m2 (group B — 17 patients). The control group consisted of 9 healthy children. Probability of differences between groups was determined by the t criterion (Student’s). Correlations between the parameters were studied using r coefficient (Spearman’s).
Results. The interdependence between high consumption of oxygen and nitric oxide metabolites levels has been shown. The correlation between nitric oxide hyperproduction and accelerated blood flow in arterial and venous vessels of portal area has been demonstrated.
Conclusions. In children with sepsis, there is a significant increased NO production, which correlates with indicators of cardiac output, splanichnic circulation, oxygen delivery and consumption.


sepsis; children; nitric oxide; portal circulation


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