N-acetylcysteine for preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass.
OBJECTIVE
To investigate the effect of N-acetylcysteine on preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass (CPB).


METHODS
Forty patients undergoing coronary artery bypass grafting (CABG) were randomly divided into a study group (n = 20), given 50 mg kg(-1) N-acetylcysteine intravenously for 3 days, and a control group (n = 20) given saline. Serum samples were collected for measurement of myeloperoxidase (MPO), malondialdehyde (MDA), interleukin-6, Alpha1-acid glycoprotein (AAGP), and C-reactive protein (CRP) during surgery and postoperatively.


RESULTS
The MPO and MDA values showed a similar pattern during and after CPB in the study group, with significantly less variance than in the control group. Interleukin-6 showed similar patterns in the two groups, but the data from 30 min after the start of CPB and from 6 h post-CPB were significantly different. The AAGP and CRP values were both elevated during CPB in the two groups without a significant difference, but 6 and 24 h post-CPB, the values were significantly higher in the control group than in the study group.


CONCLUSIONS
N-Acetylcysteine decreased pump-induced oxidoinflammatory response during CPB, suggesting that it could be a novel therapy for assisting in the prevention of CBP-induced oxidoinflammatory damage.
Department of Cardiovascular Surgery, Mersin University, Medical School, Zeytinlibahce Cad., 33079 Mersin, Turkey.
Nehir
N
Sucu
Ismail
I
Cinel
Ali
A
Unlu
Barlas
B
Aytacoglu
Lülüfer
L
Tamer
Zeliha
Z
Kocak
Kerem
K
Karaca
Ali
A
Gul
Murat
M
Dikmengil
Ugur
U
Atik
Ugur
U
Oral
D000111:Acetylcysteine / Q000494:pharmacology*; D000209:Acute-Phase Proteins / Q000032:analysis; D000975:Antioxidants / Q000494:pharmacology*; D002097:C-Reactive Protein / Q000032:analysis; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D018836:Inflammation Mediators / Q000032:analysis*; D015850:Interleukin-6 / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects*; D008315:Malondialdehyde / Q000097:blood; D018375:Neutrophil Activation / Q000187:drug effects*; D009961:Orosomucoid / Q000032:analysis; D018384:Oxidative Stress; D009195:Peroxidase / Q000378:metabolism
D000209:Acute-Phase Proteins; D000975:Antioxidants; D018836:Inflammation Mediators; D015850:Interleukin-6; D009961:Orosomucoid; D008315:Malondialdehyde; D002097:C-Reactive Protein; D009195:Peroxidase; D000111:Acetylcysteine