Document Detail


Effects of N-acetylcysteine on pulmonary function in patients undergoing coronary artery bypass surgery with cardiopulmonary bypass.
MedLine Citation:
PMID:  14714769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiopulmonary bypass (CPB) has been implicated in causing poor pulmonary gas exchange postoperatively in patients undergoing coronary artery bypass grafting (CABG) procedures. In this prospective, randomized, double-blind, placebo-controlled study, we examined the pulmonary effects of N-acetylcysteine (NAC) in patients undergoing CABG. Twenty patients undergoing elective CABG and early tracheal extubation were randomized into two groups. Group I (ten patients) received a physiologic salt solution as a placebo in a continuous intravenous infusion for one hour before CPB and 24 hours after CPB; Group II (ten patients) received 100 mg/ kg NAC intravenously for one hour before CPB and 40 mg/kg/day at 24 hours after CPB. Perioperative hemodynamic and pulmonary data were recorded. Postoperative tracheal extubation was accomplished at the earliest appropriate time. The postoperative clinical course was similar in the two groups. Both groups exhibited significant postoperative increases in A-a oxygen gradient (p < 0.01), but patients in Group II exhibited significantly lower increases in postoperative A-a oxygen gradient (p < 0.006). Other hemodynamic and pulmonary data (pulmonary capillary wedge pressure, pulmonary vascular resistance (PVR), cardiac index (CI), shunt flow, dynamic lung compliance and static lung compliance) exhibited no differences between the groups. There was no significant difference in terms of intubation time. The malondialdehyde (MDA) increase in Group II following CPB was found to be significantly lower than in Group I (p = 0.043). This clinical study reveals that administration of NAC to patients undergoing elective CABG with CPB improves systemic oxygenation. There was no effect in other pulmonary parameters and in terms of intubation time.
Authors:
Nesimi Eren; Omer Cakir; Ahmet Oruc; Ziya Kaya; Levent Erdinc
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Perfusion     Volume:  18     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2004-01-12     Completed Date:  2005-04-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  345-50     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Dicle University, School of Medicine, Diyarbakir, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Acetylcysteine / therapeutic use*
Cardiopulmonary Bypass*
Coronary Artery Bypass*
Double-Blind Method
Female
Humans
Lipid Peroxidation
Male
Middle Aged
Placebos
Prospective Studies
Pulmonary Gas Exchange / drug effects*
Respiratory Function Tests
Chemical
Reg. No./Substance:
0/Placebos; 616-91-1/Acetylcysteine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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