Grant E Sklar1, Malar Subramaniam. 1. Department of Pharmacy, National University of Department of Pharmacy, and National University Hospital, Singapore. phages@nus.edu.sg
Abstract
OBJECTIVE: To evaluate the effectiveness of intravenous acetylcysteine in the treatment of non-acetaminophen-induced acute liver failure (ALF). DATA SOURCES: A search of MEDLINE (1966-March 2003), International Pharmaceutical Abstracts (1970-2003), and Cochrane Library (2003, issue 3) databases was conducted, using the search terms acetylcysteine, non-acetaminophen-induced hepatic failure, liver failure, intravenous, and treatment. DATA SYNTHESIS: All of the studies found were small and do not provide conclusive evidence that acetylcysteine benefits this subgroup of patients. Microvascular regional benefits were seen, but clinical outcomes have not been studied. CONCLUSIONS: Intravenous acetylcysteine should not be used routinely for treatment of non-acetaminophen-induced ALF. Further large-scale studies are needed to evaluate clinical outcomes.
OBJECTIVE: To evaluate the effectiveness of intravenous acetylcysteine in the treatment of non-acetaminophen-induced acute liver failure (ALF). DATA SOURCES: A search of MEDLINE (1966-March 2003), International Pharmaceutical Abstracts (1970-2003), and Cochrane Library (2003, issue 3) databases was conducted, using the search terms acetylcysteine, non-acetaminophen-induced hepatic failure, liver failure, intravenous, and treatment. DATA SYNTHESIS: All of the studies found were small and do not provide conclusive evidence that acetylcysteine benefits this subgroup of patients. Microvascular regional benefits were seen, but clinical outcomes have not been studied. CONCLUSIONS: Intravenous acetylcysteine should not be used routinely for treatment of non-acetaminophen-induced ALF. Further large-scale studies are needed to evaluate clinical outcomes.
Authors: Robert H Squires; Anil Dhawan; Estella Alonso; Michael R Narkewicz; Benjamin L Shneider; Norberto Rodriguez-Baez; Dominic Dell Olio; Saul Karpen; John Bucuvalas; Steven Lobritto; Elizabeth Rand; Philip Rosenthal; Simon Horslen; Vicky Ng; Girish Subbarao; Nanda Kerkar; David Rudnick; M James Lopez; Kathleen Schwarz; Rene Romero; Scott Elisofon; Edward Doo; Patricia R Robuck; Sharon Lawlor; Steven H Belle Journal: Hepatology Date: 2013-02-04 Impact factor: 17.425
Authors: William M Lee; Linda S Hynan; Lorenzo Rossaro; Robert J Fontana; R Todd Stravitz; Anne M Larson; Timothy J Davern; Natalie G Murray; Timothy McCashland; Joan S Reisch; Patricia R Robuck Journal: Gastroenterology Date: 2009-06-12 Impact factor: 22.682