Influence of N-acetylcysteine on indirect indicators of tissue oxygenation in septic shock patients: Results from a prospective, randomized, double-blind study

Spies, Claudia; Reinhart, Konrad; Witt, I.; Meier‐Hellmann, Andreas; Hannemann, L.; Bredle, Donald L.; Schaffartzik, Walter

doi:10.1097/00003246-199411000-00007

Cited by 77 publications

(67 citation statements)

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“…Similar protection to endogenous mechanisms against free radical mediated injury might be achieved with exogenous agents such as N-acetylcysteine (NAC), which has been in clinical practice for 40 years, historically for cystic fibrosis and chronic bronchitis and later for paracetamol overdose. Based on the encouraging results of benefit in clinical studies of patients with adult respiratory distress syndrome (ARDS) and sepsis [10][11][12], where NAC was used as a free radical scavenger, we decided to investigate the early use of NAC in a heterogeneous critically ill population.…”

Section: Introductionmentioning

confidence: 99%

The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients

Molnár

MacKinnon²,

Shearer

et al. 1998

Intensive Care Med

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Section: Introductionmentioning

confidence: 99%

The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients

Molnár

MacKinnon²,

Shearer

et al. 1998

Intensive Care Med

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“…4). Significantly lower serum CRP levels were observed in the NAC group at t 24 Preoperative M:Cr values were within the normal range. There was a significant increase in M:Cr on admission to the ICU (t 0 ), but levels returned to normal within 6 h and remained so for the rest of the study.…”

Section: Procalcitonin C-reactive Protein and Microalbuminuriamentioning

confidence: 74%

“…The boxes enclose the interquartile range and median (middle line in each box); the whiskers enclose the minimum and maximum. Differences between the two groups at each assessment point were tested using the Mann-Whitney U-test matory process might improve outcome [23,24]. Unfortunately, real pre-treatment of septic patients cannot be achieved in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…N-acetylcysteine has important antioxidant properties, decreases neutrophil-aggregating activity and enhances nitric oxide release by the endothelium [13,14,15]. Despite the theoretical advantages, the benefit of NAC to critically ill patients remains controversial [23,24,28,29,30]. However, encouraging results have also been published.…”

Section: Discussionmentioning

confidence: 99%

“…One of the reasons could be that PCT release might be linked to pathways taking place in other organs than the liver and not directly influenced by OFR production. Another likely possibility is that NAC is unable to interfere with the pathophysiological events following surgery, as indicated by several clinical trials with negative results [23,24,28,39].…”

Section: N-acetylcysteine and Procalcitoninmentioning

confidence: 99%

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Prophylactic N-acetylcysteine decreases serum CRP but not PCT levels and microalbuminuria following major abdominal surgery. A prospective, randomised, double-blinded, placebo-controlled clinical trial

2003

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Understanding the Inflammatory Cytokine Response in Pneumonia and Sepsis

Kong²,

et al. 2007

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Background: Severe sepsis is common and frequently fatal, and community-acquired pneumonia (CAP) is the leading cause. Although severe sepsis is often attributed to uncontrolled and unbalanced inflammation, evidence from humans with infection syndromes across the breadth of disease is lacking. In this study we describe the systemic cytokine response to pneumonia and determine if specific patterns, including the balance of proinflammatory and anti-inflammatory markers, are associated with severe sepsis and death.Methods: This is a cohort study of 1886 subjects hospitalized with CAP through the emergency departments in 28 US academic and community hospitals. We defined severe sepsis as CAP complicated by new-onset organ dysfunction, following international consensus conference criteria. We measured plasma tumor necrosis factor, IL-6 (interleukin 6), and IL-10 levels daily for the first week and weekly thereafter. Our main outcome measures were severe sepsis and 90-day mortality.Results: A total of 583 patients developed severe sepsis (31%), of whom 149 died (26%). Systemic cytokine level Conclusions:The circulating cytokine response to pneumonia is heterogeneous and continues for more than a week after presentation, with considerable overlap between those who do and do not develop severe sepsis. Unbalanced activation is uncommon, and mortality is highest when both proinflammatory and antiinflammatory cytokine levels are high.

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Influence of N-acetylcysteine on indirect indicators of tissue oxygenation in septic shock patients: Results from a prospective, randomized, double-blind study

Cited by 77 publications

References 0 publications

The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients

The effect of N-acetylcysteine on total serum anti-oxidant potential and urinary albumin excretion in critically ill patients

Prophylactic N-acetylcysteine decreases serum CRP but not PCT levels and microalbuminuria following major abdominal surgery. A prospective, randomised, double-blinded, placebo-controlled clinical trial

Understanding the Inflammatory Cytokine Response in Pneumonia and Sepsis

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