Nitric Oxide and Septic Shock

CASE REPORTS 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⁻¹and 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