The nitric oxide pathway antagonists in septic shock: Meta-analysis of controlled clinical trials

Nitric oxide antagonists are effective to reverse hypotension and septic shock. Nitric oxide antagonists decrease survival rate. Nitric oxide antagonists increase number of adverse effects and length of stay in the ICU. Our intention was to obtain a quantitative summary of these diverse antagonistic agent effects along the NO pathway using the available clinical trials. New drugs RCTs have systematically failed to prove a benefit in septic shock patient survival. Small trials often times suggest possible advantages that are denied by confirmatory larger trials. The absence of a prior power analysis by the small studies could be the explanation for these contradictory results. Nitric oxide production has been associated to hypotension resistant to fluid resuscitation and ultimately multiple organ dysfunction. Non-selective opposition to NO production or to its effects has not resulted in improved long-term outcome and survival despite the fact blood pressure is improved in the short-term. Several explanations can be offered for such adverse outcome.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news