title: Improved oxidative status in major abdominal surgery patients after N-acetyl cystein supplementation.
abstract: BACKGROUND
  Increased levels of reactive oxygen species during and after surgery may affect inflammatory response, post-operative adhesion molecule formation, and hemodynamic stability. The glutathione redox cycle is an important regulator in oxidative stress and its reduced forms scavenge free radicals. N-acetyl cysteine, a precursor of reduced glutathione, is considered as a potentially therapeutic wide spectrum agent in clinical practice. We therefore examined whether N-acetyl cysteine improves some biochemical parameters in cancer patients undergoing major abdominal surgery.
  
  
  METHODS
  Thirty-three patients diagnosed with pancreas, stomach, rectum, colon malignancies, and undergoing major abdominal surgery at Ankara Numune Training and Research Hospital were randomly divided into two groups; control (CON) and N-acetyl cysteine (NAC). The NAC group had 1,200 mg N-acetyl cysteine starting two days before the operation day, in addition to isonitrogenous and isocaloric total parenteral nutrition of 1.2 g/kg protein, 25 kcal/kg, and 60:40 carbohydrate/fat ratio. Blood and urine samples were drawn two days before the operation, on operation day, and on the first, third, and fifth days post-operation.
  
  
  RESULTS
  Plasma malondialdehyde was significantly lower in the NAC group (P < 0.001). N-acetyl cysteine treatment did not affect plasma levels of vitamin A, C or E. The NAC group exhibited a higher ratio of reduced glutathione to oxidised glutathione (P = 0.019). Urinary nitrate level was also significantly lower in the NAC group (P = 0.016).
  
  
  CONCLUSIONS
  The study demonstrated the clinical importance of N-acetyl cysteine supplementation on antioxidant parameters in abdominal surgery patients. In these patients N-acetyl cysteine and vitamin administration can be considered as an effective method for improvement of oxidative status.
authors.forename: Aygun
authors.initials: A
authors.lastname: Kuyumcu
authors.forename: Asli
authors.initials: A
authors.lastname: Akyol
authors.forename: Zehra
authors.initials: Z
authors.lastname: Buyuktuncer
authors.forename: M Mahir
authors.initials: MM
authors.lastname: Ozmen
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey. htbf@hacettepe.edu.tr.
authors.forename: Halit Tanju
authors.initials: HT
authors.lastname: Besler
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000111:Acetylcysteine / Q000008:administration & dosage*; D000368:Aged; D000975:Antioxidants / Q000032:analysis*; D003110:Colonic Neoplasms / Q000601:surgery; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009566:Nitrates / Q000652:urine; D018384:Oxidative Stress / Q000187:drug effects*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D017382:Reactive Oxygen Species / Q000097:blood; D012004:Rectal Neoplasms / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery
chemical_list: D000975:Antioxidants; D009566:Nitrates; D017382:Reactive Oxygen Species; D008315:Malondialdehyde; D005978:Glutathione; D000111:Acetylcysteine