N-acetylcysteine for preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass

Surg Today. 2004;34(3):237-42. doi: 10.1007/s00595-003-2699-8.

Abstract

Purpose: To investigate the effect of N-acetylcysteine on preventing pump-induced oxidoinflammatory response during cardiopulmonary bypass (CPB).

Methods: Forty patients undergoing coronary artery bypass grafting (CABG) were randomly divided into a study group (n = 20), given 50 mg kg(-1) N-acetylcysteine intravenously for 3 days, and a control group (n = 20) given saline. Serum samples were collected for measurement of myeloperoxidase (MPO), malondialdehyde (MDA), interleukin-6, Alpha1-acid glycoprotein (AAGP), and C-reactive protein (CRP) during surgery and postoperatively.

Results: The MPO and MDA values showed a similar pattern during and after CPB in the study group, with significantly less variance than in the control group. Interleukin-6 showed similar patterns in the two groups, but the data from 30 min after the start of CPB and from 6 h post-CPB were significantly different. The AAGP and CRP values were both elevated during CPB in the two groups without a significant difference, but 6 and 24 h post-CPB, the values were significantly higher in the control group than in the study group.

Conclusions: N-Acetylcysteine decreased pump-induced oxidoinflammatory response during CPB, suggesting that it could be a novel therapy for assisting in the prevention of CBP-induced oxidoinflammatory damage.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / pharmacology*
  • Acute-Phase Proteins / analysis
  • Antioxidants / pharmacology*
  • C-Reactive Protein / analysis
  • Cardiopulmonary Bypass / adverse effects*
  • Coronary Artery Bypass
  • Humans
  • Inflammation / prevention & control
  • Inflammation Mediators / analysis*
  • Interleukin-6 / blood
  • Lipid Peroxidation / drug effects*
  • Malondialdehyde / blood
  • Neutrophil Activation / drug effects*
  • Orosomucoid / analysis
  • Oxidative Stress
  • Peroxidase / metabolism

Substances

  • Acute-Phase Proteins
  • Antioxidants
  • Inflammation Mediators
  • Interleukin-6
  • Orosomucoid
  • Malondialdehyde
  • C-Reactive Protein
  • Peroxidase
  • Acetylcysteine