Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn

Burns. 2012 May;38(3):428-37. doi: 10.1016/j.burns.2011.09.011. Epub 2011 Oct 5.


Oxidative stress and inflammation generate edema in burns. The aim of our study was to assess effect of N-acetylcysteine (NAC) on oxidative stress, inflammation, fluid requirement, multiple organ dysfunction (MOD) score and vasoactive drug requirement. In this study 15 patients were on standard therapy, whereas for other 15 patients NAC was supplemented. Blood samples were taken on admission and on the next five consecutive mornings. Levels of malondialdehyde, protein sulfhydril (PSH) groups, reduced gluthation (GSH), activity of myeloperoxidase, catalase and superoxide dismutase enzymes and induced free radical generating capacity were measured as well as concentrations of TNF-α, IL-6, IL-8, and IL-10. MOD score, use of vasopressor agents and fluid utilisation were recorded daily. NAC treatment increased GSH level on days 4-5 (p<0.05) and PSH level on days 2-6 (p<0.05) compared to controls. Plasma IL-6 was lower on days 4-5 (p<0.05), IL-8 on days 4-6 (p<0.05) and IL-10 on days 4-6 (p<0.05) in NAC group. NAC group received less catecholamines than controls (p<0.01) from day 4 without significant differences in MOD score. NAC treatment is associated with a diminished oxidative stress reflected in preserved antioxidant levels, lower inflammation mirrored in lower interleukin levels and less vasopressor requirement.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Adult
  • Aged
  • Antioxidants / metabolism
  • Biomarkers / metabolism
  • Burns / drug therapy*
  • Burns / metabolism
  • Catalase / metabolism
  • Cytokines / metabolism*
  • Female
  • Free Radical Scavengers / therapeutic use*
  • Glutathione / metabolism
  • Humans
  • Leukocyte Count
  • Male
  • Malondialdehyde / metabolism
  • Middle Aged
  • Multiple Organ Failure / metabolism
  • Oxidative Stress / drug effects*
  • Peroxidase / metabolism
  • Prospective Studies
  • Superoxide Dismutase / metabolism
  • Systemic Inflammatory Response Syndrome / drug therapy*
  • Systemic Inflammatory Response Syndrome / metabolism


  • Antioxidants
  • Biomarkers
  • Cytokines
  • Free Radical Scavengers
  • Malondialdehyde
  • Catalase
  • Peroxidase
  • Superoxide Dismutase
  • Glutathione
  • Acetylcysteine