OBJECTIVE: To examine whether the antioxidant N-acetylcysteine could ameliorate the course of the adult respiratory distress syndrome (ARDS) in man. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Medical and surgical ICU in a regional hospital. PATIENTS: Sixty-six ICU patients with ARDS. INTERVENTIONS:Patients with ARDS (PaO2/FiO2 ratio less than 250 torr) were treated with either the antioxidant N-acetylcysteine 150 mg/kg as a loading dose and then 20 mg/kg/hr, or with placebo for 6 days. MEASUREMENTS AND MAIN RESULTS: No improvement could be demonstrated in the PaO2/FiO2 ratio in the study group as compared with the control group on any day. Pulmonary compliance was higher in the N-acetylcysteine group than in the placebo group on all days, but this difference did not reach the chosen 5% level of significance. No difference between the two groups could be demonstrated on chest radiograph or on survival rate. We documented that N-acetylcysteine acts as an anticoagulant and perhaps decreases pulmonary fibrin uptake during ARDS. CONCLUSIONS: N-acetylcysteine might be of benefit in ARDS. Before further clinical studies are started, problems with N-acetylcysteine and coagulation have to be elucidated in order to find out whether N-acetylcysteine could have a beneficial effect in the treatment of ARDS.
RCT Entities:
OBJECTIVE: To examine whether the antioxidant N-acetylcysteine could ameliorate the course of the adult respiratory distress syndrome (ARDS) in man. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Medical and surgical ICU in a regional hospital. PATIENTS: Sixty-six ICU patients with ARDS. INTERVENTIONS:Patients with ARDS (PaO2/FiO2 ratio less than 250 torr) were treated with either the antioxidant N-acetylcysteine 150 mg/kg as a loading dose and then 20 mg/kg/hr, or with placebo for 6 days. MEASUREMENTS AND MAIN RESULTS: No improvement could be demonstrated in the PaO2/FiO2 ratio in the study group as compared with the control group on any day. Pulmonary compliance was higher in the N-acetylcysteine group than in the placebo group on all days, but this difference did not reach the chosen 5% level of significance. No difference between the two groups could be demonstrated on chest radiograph or on survival rate. We documented that N-acetylcysteine acts as an anticoagulant and perhaps decreases pulmonary fibrin uptake during ARDS. CONCLUSIONS:N-acetylcysteine might be of benefit in ARDS. Before further clinical studies are started, problems with N-acetylcysteine and coagulation have to be elucidated in order to find out whether N-acetylcysteine could have a beneficial effect in the treatment of ARDS.
Authors: Ognjen Gajic; Ousama Dabbagh; Pauline K Park; Adebola Adesanya; Steven Y Chang; Peter Hou; Harry Anderson; J Jason Hoth; Mark E Mikkelsen; Nina T Gentile; Michelle N Gong; Daniel Talmor; Ednan Bajwa; Timothy R Watkins; Emir Festic; Murat Yilmaz; Remzi Iscimen; David A Kaufman; Annette M Esper; Ruxana Sadikot; Ivor Douglas; Jonathan Sevransky; Michael Malinchoc Journal: Am J Respir Crit Care Med Date: 2010-08-27 Impact factor: 21.405
Authors: P Krafft; P Fridrich; T Pernerstorfer; R D Fitzgerald; D Koc; B Schneider; A F Hammerle; H Steltzer Journal: Intensive Care Med Date: 1996-06 Impact factor: 17.440
Authors: Sweta J Thakur; Cesar A Trillo-Alvarez; Michael M Malinchoc; Rahul Kashyap; Lokendra Thakur; Adil Ahmed; Martin K Reriani; Rodrigo Cartin-Ceba; Jeff A Sloan; Ognjen Gajic Journal: BMC Emerg Med Date: 2010-04-27