title: Pulmonary impact of N-acetylcysteine in a controlled hemorrhagic shock model in rats.
abstract: BACKGROUND
  Experimental hemorrhagic shock (HS) is based on controlling bleeding and the treatment of fluid resuscitation to restore tissue oxygenation and perfusion. The HS could promote ischemia/reperfusion injury, which induces a general exacerbation of the inflammatory process, initially compromising the lungs. N-acetylcysteine (NAC), an antioxidant, may attenuate ischemia/reperfusion injury. This study evaluated the effect of NAC in association with fluid resuscitation on pulmonary injury in a controlled HS model in rats.
  
  
  METHODS
  Male Wistar rats were submitted to controlled HS (mean arterial pressure of 35 mm Hg for 60 min). Two groups were constituted according to resuscitation solution administered: RLG (Ringer's lactate solution) and RLG+NAC (Ringer's lactate in association with 150 mg/kg NAC. A control group was submitted to catheterization only. After 120 min of resuscitation, bronchoalveolar lavage was performed to assess intra-alveolar cell infiltration and pulmonary tissue was collected for assessment of malondialdehyde, interleukin 6, and interleukin 10 and histopathology.
  
  
  RESULTS
  Compared with the RLG group, the RLG+NAC group showed lower bronchoalveolar lavage inflammatory cell numbers, lower interstitial inflammatory infiltration in pulmonary parenchyma, and lower malondialdehyde concentration. However, tissue cytokine (interleukin 6 and interleukin 10) expression levels were similar.
  
  
  CONCLUSIONS
  N-acetylcysteine was associated with fluid resuscitation-attenuated oxidative stress and inflammatory cell infiltration in pulmonary parenchyma. N-acetylcysteine did not modify cytokine expression.
authors.affiliation: Department of Surgery, Medical School, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Karen Ruggeri
authors.initials: KR
authors.lastname: Saad
authors.forename: Paulo Fernandes
authors.initials: PF
authors.lastname: Saad
authors.forename: Luiz
authors.initials: L
authors.lastname: Dantas Filho
authors.forename: Jôse Mára de
authors.initials: JM
authors.lastname: Brito
authors.forename: Marcia Kiyomi
authors.initials: MK
authors.lastname: Koike
authors.forename: Fernando Luiz
authors.initials: FL
authors.lastname: Zanoni
authors.forename: Marisa
authors.initials: M
authors.lastname: Dolhnikoff
authors.forename: Edna Frasson de Souza
authors.initials: EF
authors.lastname: Montero
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology* / Q000627:therapeutic use*; D055371:Acute Lung Injury / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D000818:Animals; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use; D004195:Disease Models, Animal; D005440:Fluid Therapy; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008168:Lung / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D018384:Oxidative Stress / Q000187:drug effects; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000150:complications*
chemical_list: D000975:Antioxidants; D015850:Interleukin-6; D016753:Interleukin-10; D008315:Malondialdehyde; D000111:Acetylcysteine