N-acetylcysteine for sepsis and systemic inflammatory response in adults

Abstract

Overall, this meta-analysis puts doubt on the safety and utility of intravenous N-acetylcysteine as an adjuvant therapy in SIRS and sepsis. At best, N-acetylcysteine is ineffective in reducing mortality and complications in this patient population. At worst, it can be harmful, especially when administered later than 24 hours after the onset of symptoms, by causing cardiovascular depression. Unless future RCTs provide evidence of treatment effect, clinicians should not routinely use intravenous N-acetylcysteine in SIRS or sepsis and academics should not promote its use.

Clinical management of acute liver failure: Results of an international multi-center survey

“…Most centers administered NAC to the majority of patients early in the course of illness as part of ward and especially ICU based care. This is inspite of recent data suggesting that NAC is ineffective in critically ill patients[ 9 ], over 80% of the responders also routinely administered NAC to non-paracetamol ALF, in concordance with the findings of a recent RCT[ 10 ].…”

Clinical management of acute liver failure: Results of an international multi-center survey

“…Most centers administered NAC to the majority of patients early in the course of illness as part of ward and especially ICU based care. This is inspite of recent data suggesting that NAC is ineffective in critically ill patients[ 9 ], over 80% of the responders also routinely administered NAC to non-paracetamol ALF, in concordance with the findings of a recent RCT[ 10 ].…”

A ratiometric nanoprobe for the in vivo bioimaging of hypochlorous acid to detect drug-damaged liver and kidneys

“…N -Acetylcysteine (NAC) is a strong reactive oxygen scavenger that could excellently remove the mass of intracellular HClO. 62–66 Compared with the dosing group, the NAC group showed a better inhibitory effect, which further confirmed the specific response of NRH-800-PEG to HClO. In order to calculate the content of HClO in vivo , as shown in Fig.…”

Circulating N-lactoyl-amino acids and N-formyl-methionine reflect mitochondrial dysfunction and predict mortality in septic shock

“…Second, tryptophan was decreased and its breakdown product kynurenate was increased, consistent with increased tryptophan catabolism through the kynurenine pathway (Zeden et al, 2010 ). Third, the anti-oxidant N-acetylcysteine (NAC), which has been studied as a therapy in sepsis clinical trials (Szakmany et al, 2012 ), was significantly increased. Our findings that 5-methylcytosine, N-acetylalanine and N-acetylputrescine are significantly increased in septic shock have not been explored in detail previously.…”

Clinical management of acute liver failure: Results of an international multi-center survey

“…Most centers administered NAC to the majority of patients early in the course of illness as part of ward and especially ICU based care. This is inspite of recent data suggesting that NAC is ineffective in critically ill patients[ 9 ], over 80% of the responders also routinely administered NAC to non-paracetamol ALF, in concordance with the findings of a recent RCT[ 10 ].…”

A ratiometric nanoprobe for the in vivo bioimaging of hypochlorous acid to detect drug-damaged liver and kidneys

“…N -Acetylcysteine (NAC) is a strong reactive oxygen scavenger that could excellently remove the mass of intracellular HClO. 62–66 Compared with the dosing group, the NAC group showed a better inhibitory effect, which further confirmed the specific response of NRH-800-PEG to HClO. In order to calculate the content of HClO in vivo , as shown in Fig.…”

Circulating N-lactoyl-amino acids and N-formyl-methionine reflect mitochondrial dysfunction and predict mortality in septic shock

“…Second, tryptophan was decreased and its breakdown product kynurenate was increased, consistent with increased tryptophan catabolism through the kynurenine pathway (Zeden et al, 2010 ). Third, the anti-oxidant N-acetylcysteine (NAC), which has been studied as a therapy in sepsis clinical trials (Szakmany et al, 2012 ), was significantly increased. Our findings that 5-methylcytosine, N-acetylalanine and N-acetylputrescine are significantly increased in septic shock have not been explored in detail previously.…”

Clinical management of acute liver failure: Results of an international multi-center survey

“…Most centers administered NAC to the majority of patients early in the course of illness as part of ward and especially ICU based care. This is inspite of recent data suggesting that NAC is ineffective in critically ill patients[ 9 ], over 80% of the responders also routinely administered NAC to non-paracetamol ALF, in concordance with the findings of a recent RCT[ 10 ].…”

A ratiometric nanoprobe for the in vivo bioimaging of hypochlorous acid to detect drug-damaged liver and kidneys

“…N -Acetylcysteine (NAC) is a strong reactive oxygen scavenger that could excellently remove the mass of intracellular HClO. 62–66 Compared with the dosing group, the NAC group showed a better inhibitory effect, which further confirmed the specific response of NRH-800-PEG to HClO. In order to calculate the content of HClO in vivo , as shown in Fig.…”

Circulating N-lactoyl-amino acids and N-formyl-methionine reflect mitochondrial dysfunction and predict mortality in septic shock

“…Second, tryptophan was decreased and its breakdown product kynurenate was increased, consistent with increased tryptophan catabolism through the kynurenine pathway (Zeden et al, 2010 ). Third, the anti-oxidant N-acetylcysteine (NAC), which has been studied as a therapy in sepsis clinical trials (Szakmany et al, 2012 ), was significantly increased. Our findings that 5-methylcytosine, N-acetylalanine and N-acetylputrescine are significantly increased in septic shock have not been explored in detail previously.…”