title: Cardiovascular effects of N-acetylcysteine in meconium-induced acute lung injury.
abstract: Anti-inflammatory drugs are increasingly used for treatment of neonatal meconium aspiration syndrome (MAS), but their adverse effects are poorly known. Therefore, the aim of this study was to evaluate the effects of the antioxidant N-acetylcysteine on cardiovascular parameters in an animal model of MAS. Oxygen-ventilated rabbits were intratracheally instilled 4 mL/kg of meconium suspension (25 mg/mL) or saline. Thirty minutes later, meconium-instilled animals were given N-acetylcysteine (10 mg/kg, i.v.) or the same volume of saline. Changes in cardiovascular parameters (blood pressure, heart rate, and heart rate variability) were recorded over a 5-min course of solution administration, over 5 min after its end, and then hourly for 5 h. Oxidation markers (thiobarbituric acid-reactive substances (TBARS) and total antioxidant status) and aldosterone, as a non-specific marker of cardiovascular injury, were determined in plasma. Meconium instillation did not evoke any significant cardiovascular changes, but induced oxidative stress and elevated plasma aldosterone. N-acetylcysteine significantly reduced the mentioned markers of injury. However, its administration was associated with short-term increases in blood pressure and in several parameters of heart rate variability. Considering these effects of N-acetylcysteine, its intravenous administration in newborns with MAS should be carefully monitored.
authors.affiliation: Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 4 Mala Hora St., SK-03601, Martin, Slovakia, mokra@jfmed.uniba.sk.
authors.forename: D
authors.initials: D
authors.lastname: Mokra
authors.forename: I
authors.initials: I
authors.lastname: Tonhajzerova
authors.forename: H
authors.initials: H
authors.lastname: Pistekova
authors.forename: Z
authors.initials: Z
authors.lastname: Visnovcova
authors.forename: A
authors.initials: A
authors.lastname: Drgova
authors.forename: J
authors.initials: J
authors.lastname: Mokry
authors.forename: A
authors.initials: A
authors.lastname: Calkovska
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology*; D055371:Acute Lung Injury / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D000450:Aldosterone / Q000097:blood; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D000975:Antioxidants / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004195:Disease Models, Animal; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007275:Injections, Intravenous; D007442:Intubation, Intratracheal; D008168:Lung / Q000187:drug effects / Q000503:physiopathology; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D018384:Oxidative Stress; D011817:Rabbits; D012121:Respiration, Artificial; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D017392:Thiobarbituric Acid Reactive Substances; D000450:Aldosterone; D000111:Acetylcysteine