TITLE

Effects of N-acetylcysteine on pulmonary function in patients undergoing coronary artery bypass surgery with cardiopulmonary bypass

AUTHOR(S)
Eren, Nesimi; Çkir, Ömer; Oruc, Ahmet; Kaya, Ziya; Erdinc, Levent
PUB. DATE
November 2003
SOURCE
Perfusion;Nov2003, Vol. 18 Issue 6, p345
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Cardiopulmonary bypass (CPB) has been implicated in causing poor pulmonary gas exchange postoperatively in patients undergoing coronary artery bypass grafting (CABG) procedures. In this prospective, randomized, double-blind, placebo-controlled study, we examined the pulmonary effects of N-acetylcysteine (NAC) in patients undergoing CABG. Twenty patients undergoing elective CABG and early tracheal extubation were randomized into two groups. Group I (ten patients) received a physiologic salt solution as a placebo in a continuous intravenous infusion for one hour before CPB and 24 hours after CPB; Group II (ten patients) received 100 mg/ kg NAC intravenously for one hour before CPB and 40 mg/kg/day at 24 hours after CPB. Perioperative hemodynamic and pulmonary data were recorded. Postoperative tracheal extubation was accomplished at the earliest appropriate time. The postoperative clinical course was similar in the two groups. Both groups exhibited significant postoperative increases in A-a oxygen gradient (p < 0.01), but patients in Group II exhibited significantly lower increases in postoperative A-a oxygen gradient (p < 0.006). Other hemodynamic and pulmonary data (pulmonary capillary wedge pressure, pulmonary vascular resistance (PVR), cardiac index (CI), shunt flow, dynamic lung compliance and static lung compliance) exhibited no differences between the groups. There was no significant difference in terms of intubation time. The malondialdehyde (MDA) increase in Group II following CPB was found to be significantly lower than in Group I (p = 0.043). This clinical study reveals that administration of NAC to patients undergoing elective CABG with CPB improves systemic oxygenation. There was no effect in other pulmonary parameters and in terms of intubation time.
ACCESSION #
12087817

 

Related Articles

  • Comparison of two modes of ventilation after fast-track cardiac surgery: Adaptive support ventilation versus synchronized intermittent mandatory ventilation. Aghadavoudi, Omid; Kamran, Maryam; Masoudifar, Mehrdad // Pakistan Journal of Medical Sciences;Apr2012, Vol. 28 Issue 2, p303 

    Objective: There is substantial debate regarding the appropriate protocol for ventilatory management in fast-track cardiac anesthesia (FTCA). This study was carried out to assess and compare the risks and benefits of respiratory weaning based on adaptive support ventilation (ASV) and...

  • Evaluation of the efficacy of a haemostatic matrix for control of intraoperative and postoperative bleeding in major lung surgery: a prospective randomized study. D'Andrilli, Antonio; Cavaliere, Ilenia; Maurizi, Giulio; Andreetti, Claudio; Ciccone, Anna Maria; Ibrahim, Mohsen; Baldini, Rossella; Venuta, Federico; Rendina, Erino A. // European Journal of Cardio-Thoracic Surgery;Nov2015, Vol. 48 Issue 5, p679 

    OBJECTIVES: This prospective randomized study was designed to assess the safety and efficacy of a haemostatic matrix in intraoperative bleeding control and prevention of postoperative bleeding after major lung surgery. METHODS: One hundred and twenty patients undergoing major lung resection and...

  • Carotid Doppler microembolic signals in patients one year after heart valve surgery. Dalinin, Vadim; Lingaas, Per Snorre; Hatteland, Kjell; Svennevig, Jan L. // Perfusion;Nov2003, Vol. 18 Issue 6, p333 

    Doppler ultrasound has been used to detect microemboli during and after cardiopulmonary bypass (CPB). The aim of the present study was to examine the frequency of microembolic signals (MES) in patients one year after heart valve replacement, to look for possible risk factors associated with MES...

  • Mini-ventilation for improved oxygenation during lung resection surgery. SHECHTMAN, M. Y.; ZISER, A.; BARAK, M.; BEN-NUN, A. // Anaesthesia & Intensive Care;May2011, Vol. 39 Issue 3, p456 

    The article discusses the results of a study which compares the efficiency of a mini-ventilation over continuous positive airway pressure (CPAP) in improving oxygenation of patients during lung resection. According to the authors, the arterial oxygen partial pressure was remarkably higher during...

  • COPD exacerbations · 4: Prevention. Scott, S.; Walker, P.; Calverley, P. M. A. // Thorax;May2006, Vol. 61 Issue 5, p440 

    The article investigates the evidence of the effectiveness of prevention of chronic obstructive pulmonary disease (COPD) exacerbations. There is reasonable evidence showing that immunization with an appropriate polyvalent vaccine is effective. The non-pharmacological therapies include lung...

  • Perioperative extracorporeal membrane oxygenation for tracheal reconstruction in congenital tracheal stenosis. Angel, C.; Murillo, C.; Zwischenberger, J.; Swischuk, L.; Graves, D.; Chernin, J. // Pediatric Surgery International;Jan2000, Vol. 16 Issue 1/2, p98 

    The management of a critical airway in infants and toddlers with congenital tracheal stenosis (CTS) continues to be an enormous challenge to the surgeon. Until recently, this condition often proved fatal. Improvements in surgical techniques, anesthetic management, and postoperative critical care...

  • The relative safety of an oxygenator. Svenmarker, S.; Haggmark, S.; Jansson, E.; Lindholm, R.; Appelblad, M.; Aberg, T. // Perfusion;1997, Vol. 12 Issue 5, p289 

    Analysis of prospectively registered incidents related to cardiopulmonary bypass (CPB) was initiated to establish the incident rate for 10 different oxygenator brands employed over a seven-year period in 5000 clinical perfusions. A general safety index (SI) was defined as the number of recorded...

  • Editorial. Taylor, K. // Perfusion;1998, Vol. 13 Issue 3, p155 

    Editorial. Discusses on the ability of membrane oxygenators to handle and remove air. Quantification and localization of the air removal characteristics of membrane oxygenators; Analysis on the design and manufacture of cardiopulmonary bypass circuit components for neonatal and pediatric...

  • The incidence and cause of emergency oxygenator changeovers. Fisher, A.R. // Perfusion;1999, Vol. 14 Issue 3, p207 

    Emergency oxygenator changeover presents as an important potential hazard during cardiopulmonary bypass. In order to assess the frequency and possible causes of this event a retrospective survey was conducted of cardiothoracic units in the UK and Ireland. The survey was sent to these units in...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics