N‐Acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients

Vento, Antti; Nemlander, Arto; Aittomäki, Juha; Salo, Jarmo A.; Karhunen, Janne; Rämö, O. J.

doi:10.1080/14017430310015406

Cited by 31 publications

(32 citation statements)

References 10 publications

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“…Consistent with our own results, Karu et al showed that the oxidative stress (oxidized glutathione measurement) is not predictive of early postoperative left ventricular contractile function [31]. Our results are also in accordance with other reports showing no significant differences in invasive hemodynamic data between groups when different antioxidants (pyruvate, N-acetylcysteine) were added to crystalloid or blood cardioplegia solutions [32,33]. It is possible that this experimental model causes an activation of leukocytes in blood cardioplegia, which induces inflammation and histologic abnormalities [19], but these lesions are also found in the group with crystalloid cardioplegia and static storage.…”

Section: Discussionsupporting

confidence: 96%

Oxidative Stress Implication After Prolonged Storage Donor Heart with Blood Versus Crystalloid Cardioplegia and Reperfusion Versus Static Storage

Charniot

Bonnefont‐Rousselot²,

Albertini

et al. 2010

Journal of Surgical Research

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Section: Discussionsupporting

confidence: 96%

Oxidative Stress Implication After Prolonged Storage Donor Heart with Blood Versus Crystalloid Cardioplegia and Reperfusion Versus Static Storage

Charniot

Bonnefont‐Rousselot²,

Albertini

et al. 2010

Journal of Surgical Research

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“…Such patients are, for instance, those with hepatic failure awaiting a liver transplantation, and those scheduled for heart surgery. A recent study found increased postoperative blood loss in patients receiving NAC as an additive to crystalloid cardioplegia [18].…”

Section: Discussionmentioning

confidence: 99%

The effect of N-acetylcysteine on blood coagulation and platelet function in patients undergoing open repair of abdominal aortic aneurysm

Niemi

Munsterhjelm

Pöyhiä

et al. 2006

Blood Coagulation &Amp; Fibrinolysis

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N-acetylcysteine (NAC) may offer renal and hepatic protection during surgery, but in experimental studies it has been shown to impair coagulation. Since very little is known about the effects of NAC on blood coagulation in surgical patients, we studied its effects during abdominal aortic reconstruction. NAC (a bolus of 150 mg/kg followed by a continuous 24-h infusion of 150 mg/kg) or the same volume of placebo was given intravenously, in a randomized double-blinded fashion, to 20 patients undergoing abdominal aortic aneurysm repair. The haematocrit, platelet count, prothrombin time, thromboelastometry, and platelet aggregation were studied during and after surgery. Total blood loss was also measured. The median (25th-75th percentiles) decrease of the prothrombin time value was 33.0% (30-37%) after NAC treatment and 6.5% (4-8%) after placebo (P<0.001). Postoperative prothrombin time values remained lower in the patients receiving NAC. In thromboelastometry tracings the coagulation time was more prolonged after the bolus of NAC (P=0.02). Platelet aggregation induced with adenosine diphosphate decreased after NAC but not after placebo. Low prothrombin time values before and after bolus infusions were associated with increased blood loss (P=0.008 and P=0.015, respectively). NAC has anticoagulant and platelet-inhibiting properties in patients undergoing major vascular surgery. This abnormal haemostatic activity should be considered when NAC is administered to patients with increased bleeding risk.

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“…The cardioprotective efficacy of NAC in cardiac surgery has been reported in a number of recent studies [24][25][26] . However, a considerable number of studies have concluded that the use of NAC in cardiac surgery did not appear to bestow any statistically significant benefits [27,28] .…”

Section: Discussionmentioning

confidence: 99%

Ischemia-Modified Albumin Reduction after Coronary Bypass Surgery Is Associated with the Cardioprotective Efficacy of Cold-Blood Cardioplegia Enriched with N-Acetylcysteine: A Preliminary Study

Karahan¹,

Koramaz²,

Altun³

et al. 2009

Eur Surg Res

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Background: The aims of this preliminary study were to determine the alteration of serum ischemia-modified albumin (IMA) levels and to investigate whether IMA may be used as an indicator of the cardioprotective efficacy of N-acetylcysteine (NAC) in patients undergoing coronary bypass grafting (CABG). Patients and Methods: Forty-four patients were randomized into one of two groups on the basis of cardioplegic strategies, either cold-blood cardioplegia enriched with NAC (50 mg/kg) or cold-blood cardioplegia alone. Serum IMA, cardiac troponin T (cTnT) and malondialdehyde (MDA) levels determined in NAC-enriched patients before and after CABG were compared with those of the NAC-free group. The albumin cobalt binding assay was used for IMA determination. Results: Serum IMA levels were significantly elevated after cross-clamping and peaked at 6 h after reperfusion in the two groups. In NAC-enriched patients, IMA levels determined 6, 12, 24 and 48 h after reperfusion were significantly lower than those of the NAC-free group (p ≤ 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). IMA returned to baseline 24 h after reperfusion differently from cTnT and MDA in the NAC-enriched group. Conclusions: IMA may be used as not only an indicator of myocardial ischemia-reperfusion injury, but also as a useful indicator of the cardioprotective effect of NAC in CABG.

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N‐Acetylcysteine as an additive to crystalloid cardioplegia increased oxidative stress capacity in CABG patients

Abstract: NAC increased tissue capacity against oxidative stress and decreased inflammatory response in CABG patients with normal ejection fraction.

Cited by 31 publications

References 10 publications

Oxidative Stress Implication After Prolonged Storage Donor Heart with Blood Versus Crystalloid Cardioplegia and Reperfusion Versus Static Storage

Oxidative Stress Implication After Prolonged Storage Donor Heart with Blood Versus Crystalloid Cardioplegia and Reperfusion Versus Static Storage

The effect of N-acetylcysteine on blood coagulation and platelet function in patients undergoing open repair of abdominal aortic aneurysm

Ischemia-Modified Albumin Reduction after Coronary Bypass Surgery Is Associated with the Cardioprotective Efficacy of Cold-Blood Cardioplegia Enriched with N-Acetylcysteine: A Preliminary Study

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