N-acetylcysteine Protects Striated Muscle in a Model of Compartment Syndrome

Kearns, Stephen; O’Briain, D.; Sheehan, Katherine M.; Kelly, C. J.; Bouchier‐Hayes, David

doi:10.1007/s11999-010-1287-7

Cited by 7 publications

(8 citation statements)

References 47 publications

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“…Oral NAC has been rarely associated with serious adverse events. However, repeated high doses may cause nausea, vomiting, diarrhea, and rarely headache, rash, hypotension, and respiratory distress[ 55 ].…”

Section: Safety Profile and Adverse Effectsmentioning

confidence: 99%

Bottom-up analysis of emergent properties of N-acetylcysteine as an adjuvant therapy for COVID-19

Dominari

Hathaway

Kapasi

et al. 2021

WJV

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N-acetylcysteine (NAC) is an abundantly available antioxidant with a wide range of antidotal properties currently best studied for its use in treating acetaminophen overdose. It has a robustly established safety profile with easily tolerated side effects and presents the Food and Drug Administration's approval for use in treating acetaminophen overdose patients. It has been proven efficacious in off-label uses, such as in respiratory diseases, heart disease, cancer, human immunodeficiency virus infection, and seasonal influenza. Clinical trials have recently shown that NAC's capacity to replenish glutathione stores may significantly improve coronavirus disease 2019 (COVID-19) outcomes, especially in high risk individuals. Interestingly, individuals with glucose 6-phosphate dehydrogenase deficiency have been shown to experience even greater benefit. The same study has concluded that NAC's ability to mitigate the impact of the cytokine storm and prevent elevation of liver enzymes, C-reactive protein, and ferritin is associated with higher success rates weaning from the ventilator and return to normal function in COVID-19 patients. Considering the background knowledge of biochemistry, current uses of NAC in clinical practice, and newly acquired evidence on its potential efficacy against COVID-19, it is worthwhile to investigate further whether this agent can be used as a treatment or adjuvant for COVID-19.

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Section: Safety Profile and Adverse Effectsmentioning

confidence: 99%

Bottom-up analysis of emergent properties of N-acetylcysteine as an adjuvant therapy for COVID-19

Dominari

Hathaway

Kapasi

et al. 2021

WJV

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“…5 – 7 Acute compartment syndrome develops when the tissue pressure within the fascial sheath surrounding a group of muscles rises to within 30 mmHg of aortic diastolic pressure. 8 Once compartment pressure reaches this level, microvascular compression results in progressive muscle and nerve ischemia. 8 …”

Section: Discussionmentioning

confidence: 99%

“… 8 Once compartment pressure reaches this level, microvascular compression results in progressive muscle and nerve ischemia. 8 …”

Section: Discussionmentioning

confidence: 99%

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Hand Compartment Syndrome Due to N-acetylcysteine Extravasation

Thoppil

Berman

Kessler

et al. 2017

CPC-EM

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N-acetylcysteine (NAC) is the antidote for acetaminophen (APAP)-induced hepatotoxicity. Both intravenous (IV) and oral (PO) NAC formulations are available with equal efficacy. Adverse events from either preparation are rare. We describe a hand compartment syndrome after extravasation of NAC requiring emergent fasciotomy during phase three of treatment for suspected APAP toxicity. Extravasation injuries leading to compartment syndrome are rare. It is unclear whether IV NAC induced a direct tissue-toxic insult, or functioned as a space-occupying lesion to cause a compartment syndrome. Compartment syndrome from extravasation of NAC is possible. In cases where IV access is difficult, PO NAC is an alternative.

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“…Both vitamin C and N-acetylcysteine preserve muscle and decrease white cell activation in elevated compartment pressure. 1,6 Indomethacin has anti-inflammatory and antioxidant properties that may account for its protective effect against I/R. 7,8 Indomethacin's anti-inflammatory effects are mediated by its inhibition of cyclo-oxygenase and lipooxygenase.…”

Section: Discussionmentioning

confidence: 99%