[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
April 17, 1996

Nitric Oxide and Septic Shock

Author Affiliations

From the Critical Care Medicine Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Md. Dr Cobb is now with the Burn, Trauma, and Surgical Critical Care Section, Department of Surgery, Washington University, St Louis, Mo.

JAMA. 1996;275(15):1192-1196. doi:10.1001/jama.1996.03530390058035


Case 1  A 23-year-old woman presented with a 2-week history of bruising and fever. She was diagnosed as having acute myelogenous leukemia. Three days after beginning chemotherapy, she became disoriented and hypotensive. Her platelet count was 60×109/L, and her white blood cell count was 1.0×109/L, with an absolute neutrophil count of 0.48×109/L. She was resuscitated with 3 L of saline and she was given dopamine at 5 μg·kg-1·min-1 and broad-spectrum antibiotics. Her chest radiograph revealed diffuse interstitial-alveolar infiltrates. She required mechanical ventilation for progressive hypoxemia. Pulmonary and radial arterial catheters were inserted and the following hemodynamic parameters were obtained: blood pressure, 90/35 mm Hg; mean arterial pressure (MAP), 53 mm Hg; heart rate, 124 beats per minute; cardiac index, 7.8 L·min-1·m-2; central venous pressure (CVP), 12 mm Hg; pulmonary artery pressure, 42/28 mm Hg; pulmonary capillary