Research of ADMA (Asymmetricdimethylarginine) and NO (Nitric Oxide) levels in severe sepsis or septic shock patients.

Sepsis and septic shock, surgary and medical intensive care unit shock and the most common causes of death. The role inflammatory mediators in sesponse to variety of ways they interact with each other. NO causes an increase in vasuactive ADMA, NO biosynthesis is the major inhibitor in human. SDMA, ADMA is a structural isomer inactive and NOS inhibition does not. In take into the cell a high concentration of plasma SDMA, L-arginine with the race to reduce NO production indirectly. If the increase in homosistein decreased NO synthesis in acute and chronic dysfunction endotelium, ADMA and NOS inhibition also caused the accumulation has been reported.In our study, as a result of heavy inflammation in patients with severe sepsis and changes in homocysteine, ADMA and SDMA levels by HPLC (Eureka kit) together with changes in nitrite-nitrate levels were measured by Griess method and as colorimetric.According to our results in patients with severe sepsis and septic shock SDMA, nitrite-nitrate and homocysteine higher than control group. In increase, in patients with severe sepsis and septic shock SDMA and homocysteine as in both patient groups was statistically significant (p<0,05) nitrite-nitrate levels were significant only in patients with septic shock (p<0,05). Septic shock patients with severe sepsis compared with patients only SDMA was found between the values of means is statistically (p<0,05). ADMA levels compared to controls and statistically significant difference between groups was observed (p>0,05).We are suggesting that these parameters should help in diagnosis and prognosis of the patients having severe sepsis and septic shock.Key words: Severe sepsis, septic shock, asymmetric dymethlyarginine, symmetric dymethlyarginine, homocysteine, nitric oxide