The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients.
OBJECTIVE
To investigate the effects of N-acetylcysteine (NAC) when given as an early treatment to critically ill patients on the serum total anti-oxidant potential (TAP) and urine micro-albumin:creatinine (M:Cr) ratio.


METHODS
Prospective, placebo controlled double blinded clinical trial.


METHODS
General intensive care unit in a teaching hospital.


METHODS
Sixty critically ill patients were recruited but ten were withdrawn due to less than 48 h of ICU stay.


METHODS
After envelope randomisation, patients received either NAC (n = 23): a bolus of 150 mg/kg in 250 ml of 5% dextrose followed by a continuous infusion of 12 mg/kg per h in 500 ml of 5% dextrose over 24 h or, as controls (n = 27), the equal volume of placebo. Treatment lasted for a minimum of 3, up to a maximum of 5, days. Blood and urine samples were collected on admission (0 h) and then 6 hourly up 18 h.


RESULTS
There was no significant difference between NAC and placebo groups regarding the required length of inotropic support, mechanical ventilation and ICU stay. There was no significant difference in TAP or M:Cr ratio over 18 h or between the groups.


CONCLUSIONS
Our results suggest that NAC had no significant effects on the progress of the TAP and the urinary albumin excretion in our patients, which may suggest that NAC at the given dose has no clinical relevance as an early treatment in the critically ill.
Molnar
Z
Z
Department of Anaesthesia and Intensive Care, Medical University of Pécs, Hungary.
MacKinnon
K L
KL
Shearer
E
E
Lowe
D
D
Watson
I D
ID
D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000652:urine*; D000975:Antioxidants / Q000378:metabolism*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003404:Creatinine / Q000652:urine; D016638:Critical Illness; D004311:Double-Blind Method; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D011446:Prospective Studies; D012121:Respiration, Artificial; D016896:Treatment Outcome
D000975:Antioxidants; D002316:Cardiotonic Agents; D016166:Free Radical Scavengers; D003404:Creatinine; D000111:Acetylcysteine