• Rachid Zegdi, Dominique Perrin, Michèle Burdin, Richard Boiteau, and Alain Tenaillon.
• Department of Intensive Care, Louise Michel Hospital, Coucouronnes, France. rzegdi@hotmail.com
• Intensive Care Med. 2002 Jun 1; 28 (6): 793-6.

ObjectiveA comparison was made between the endogenous carbon monoxide (CO) production in mechanically ventilated critically ill adult patients with, and those without, severe sepsis.DesignProspective comparative study.SettingMedical ICU in a community hospital.PatientsTwenty-four patients with severe sepsis of various etiologies and five control patients with varying diagnoses.InterventionCO concentration was determined with an infrared CO analyzer on exhaled breath collected at the outlet of the ventilator. Endogenous CO production was estimated by the lung CO excretion rate measured at steady state.Measurements And Main Results: Endogenous CO production was higher in the sepsis group during the first 3 days of treatment in comparison to the control group (10.9+/-5 (SD) microl/kg per h on day 1, 7.8+/-4.9 microl/kg per h on day 2 and 6.9+/-4.7 microl/kg per h on day 3 versus 2.1+/-0.5 microl/kg per h; p<0.01 for each comparison). Survivors of sepsis had a significantly higher endogenous CO production on day 1 compared to non-survivors (14.7+/-5.3 versus 8.5+/-3.3 microl/kg per h; p=0.02).ConclusionEndogenous CO production was significantly higher in mechanically ventilated patients suffering from severe sepsis. Further studies are required in order to determine the mechanism(s) and the functional significance of this increase.

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