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NO in Septic Shock

  • Chapter
Nitric Oxide and the Kidney

Abstract

Despite significant improvements in critical care, septic shock remains the major cause of death in noncoronary intensive care units with an estimated mortality (gram-negative and gram-positive sepsis) ranging between 25% and 75%. Traditionally recognized as a consequence of gram-negative bacteremia, septic shock is also caused by gram-positive organisms, fungi, and probably viruses and parasites. The pattern of prevalence of nosocomial infections has changed over the past 40 years. Gram-negative infections increased notably throughout the 1950s and 1960s, and by the early 1970s, they were responsible for most cases of bacteremia in adults. In the 1980s, there was a resurgence in the frequency of reported gram-positive bacteremia and sepsis. Today, between 30% and 50% of all cases of sepsis (approximately 500,000 per year in the United States) are caused by gram-positive organisms [1]. It has been postulated that the marked increase in the incidence of sepsis and septic shock recognized over the last 15-20 years is secondary to (i) improved life-support technology which keeps intensive care patients with high risk of infection alive for prolonged periods, (ii) the prevalence of immunocompromised patients due to an increased incidence of acquired immunodeficiency syndrome or due to chemotherapy and immunotherapy, and (iii) the increased use of invasive medical procedures.

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Authors
  1. Colin G. M. Millar
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  2. Christoph Thiemermann
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  1. Department of Medicine, State University of New York, Stony Brook, NY, USA

    Michael S. Goligorsky

  2. Department of Pharmacology, Cornell University Medical College, New York, NY, USA

    Steven S. Gross

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Millar, C.G.M., Thiemermann, C. (1997). NO in Septic Shock. In: Goligorsky, M.S., Gross, S.S. (eds) Nitric Oxide and the Kidney. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6039-5_14

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