The role of nitric oxide in the clinical evolution of thermal burns in children

Abstract

Introduction: Nitric oxide (NO-) plays an important role in sepsis and polytrauma. The study shows that in thermal burns NO- is increased. Materials and Methods: Burns, Reconstructive Plastic Surgery Department, Institute of Mother and Child, Department of Surgery, orthopedics and pediatric anesthesiology of IP SMPhU, '‘Nicholae Testemitanu”, the Laboratory of Biochemistry of IP SMPhU, “Nicholae Testemitanu''. In the study were included patients aged 0-5 years, with thermal burns of I I , IIIA -B , IV degree. Burn area was more than 10 % TBSA. Results: In this research, a statistically reliable increase in the concentration of NO- at all stages of clinical evolution in children with thermal burns was demonstrated: in the toxemia phase - by 41 %, after surgery - by 54 % compared with control group. This reflects a vascular hypoactivity, myocardial dysfunction, the need for specific fluid resuscitation, inotropic therapy to improve oxygenation as well as an adequate analgesia and acid-base resuscitation. Conclusions: These data suggest that during the shock, in children with thermal burns, there is an increased level of NO- caused by gram-positive and gram-negative bacteria, which have been identified in patients in the study. Also, the formation of large amounts of NO- in the smooth muscles of blood vessels causes vascular hypoactivity (vasoplegia) to exogenous and endogenous vasoconstrictor agents. We conclude that our research suggests that NO- is a central mediator of hemodynamic disbalances in burn shock.