We wish to express our respect and appreciation for the study conducted by Dony et al (1), published in the issue of Critical Care Medicine. The research findings demonstrated an increased plasma nitric oxide (NO) consumption in patients afflicted with sepsis, acute respiratory distress syndrome (ARDS), shock, and those who succumbed in the hospital, compared with their respective negative controls. When examining the commonalities among these diseases, it becomes evident that the consumption of NO is elevated in conditions connected to hypoxia, circulatory disorders, and inflammatory stimuli. Furthermore, it is conceivable that hypoxiainducible factor-1 (HIF-1) may serve as the pivotal molecule associating critically ill patients with NO consumption.