title: Use of acetylcysteine for non-acetaminophen-induced acute liver failure.
abstract: The purpose of this review was to evaluate the effectiveness of acetylcysteine in the treatment of acute liver failure not related to acetaminophen. A search of MEDLINE April 2003 through May 2012 using the Pub Med database was conducted using the keywords acetylcysteine and non-acetaminophen-induced acute liver failure or acetylcysteine and liver failure. All human case reports, case series, and research articles that discussed the use of acetylcysteine for non-acetaminophen induced liver failure were evaluated. A total of 263 articles were identified during this broad search with 11 articles included for review in this article; eight case reports, two retrospective trials, and one prospective, randomized, double-blind multicenter study. In conclusion, the data suggest marginal benefit of IV acetylcysteine in NAI-ALF with coma grades I-II; however, the routine use of acetylcysteine cannot be recommended. It may be considered in non-transplant centers while awaiting referral or when transplantation is not an option. Further studies are necessary to determine optimal dosing, duration, and criteria for patient selection.
authors.affiliation: University of Pittsburgh Medical Center, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sales
authors.forename: Amy L
authors.initials: AL
authors.lastname: Dzierba
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Smithburger
authors.forename: Deanna
authors.initials: D
authors.lastname: Rowe
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Kane-Gill
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D017114:Liver Failure, Acute / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D016166:Free Radical Scavengers; D000111:Acetylcysteine