Oxidative-Nitrosative Stress and Myocardial Dysfunctions in Sepsis: Evidence from the Literature and Postmortem Observations

Figure 1

NOX2 expression in the cardiac tissue of a patient died following sepsis. Bright field (a) and contrast phase (b) microscopy image of human cardiac sample, demonstrating a moderate immunopositivity to anti-NOX 2 antibody (Santa Cruz, CA, USA). Personal observation of a 45-year-old septic patient admitted to an emergency unit due to acute abdominal pain and constipation. Abdominal X-ray revealed large amount of fecal content in the colon and dilated small bowel suggestive of bowel obstruction from fecal impaction. The patient was started on broad spectrum antibiotics after pan cultures were obtained and intravenous fluids were administered, and surgical evaluation was requested for possible surgical intervention of bowel obstruction. However, he had a rapid decline in clinical status with worsening hypotension. An echocardiogram revealed severe left ventricular dysfunction (EF 37%) and dilatation of the right ventricle with medium-apical akinesis. Despite a vigorous fluid resuscitation, dopamine, dobutamine, and norepinephrine infusion, the patient died.

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