Effect of N-Acetylcysteine on the Treatment of Acute Respiratory Distress Syndrome in Mechanically Ventilated Patients Admitted to the Intensive Care Unit

Overview

Journal Med J Islam Repub Iran

Specialty General Medicine

Date 2021 Jul 22

PMID 34291011

Citations 1

Authors

Mojtaba Ghorbi

Mahbobe Rashidi

Alireza Olapour

Fatemeh Javaherforooshzadeh

Reza Akhondzadeh

Affiliations

Soon will be listed here.

Abstract

N-acetylcysteine (NAC) is an antioxidant derived from the amino acid cysteine and is one of the drugs used in the treatment of respiratory diseases. The aim of this study was to investigate the effect of NAC on the treatment of acute respiratory distress syndrome in mechanically ventilated patients admitted to the intensive care unit. This study was a randomized clinical trial. Patients under mechanical ventilation admitted to the intensive care unit were examined. Patients in the intervention group received daily 150 mg/kg of NAC on the first day of admission and then 50 mg/kg up to the fourth day of admission. Patients in the control group received routine care. The vital signs, level of consciousness, and other important variables were recorded. Data were analyzed using statistical tests and SPSS software version 24. There was no significant difference between MAP, heart rate, respiratory rate, OSat, APACHE II score, and pulmonary capacity of the patients in the two groups on the first, second, third and fourth days after the intervention (p>0.05 ). There was no significant difference between the level of consciousness (according to GCS criteria), respiratory index (PAO/FIO) and PEEP of patients in the two study groups within 1 to 2 days after the intervention (p>0.05). There was a significant difference between the level of consciousness (based on GCS criteria), respiratory index (PAO/FIO) and PEEP of patients in the two study groups within 3 to 4 days after the intervention (p<0.05). There was no significant difference between the duration of hospitalization in the ICU, the time required for mechanical ventilation and the mortality rate of the patients in the two groups (p>0.05). It seems that N-acetylcysteine has a positive effect on the treatment of acute respiratory distress syndrome in mechanically ventilated patients admitted to the intensive care unit.

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References

Moradi M, Mojtahedzadeh M, Mandegari A, Soltan-Sharifi M, Najafi A, Khajavi M . The role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine. Respir Med. 2008; 103(3):434-41. DOI: 10.1016/j.rmed.2008.09.013. View

Sinha P, Flower O, Soni N . Deadspace ventilation: a waste of breath!. Intensive Care Med. 2011; 37(5):735-46. DOI: 10.1007/s00134-011-2194-4. View

Zhang Y, Ding S, Li C, Wang Y, Chen Z, Wang Z . Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis. Exp Ther Med. 2017; 14(4):2863-2868. PMC: 5590037. DOI: 10.3892/etm.2017.4891. View

Antonelli M, Conti G, Esquinas A, Montini L, Maggiore S, Bello G . A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med. 2006; 35(1):18-25. DOI: 10.1097/01.CCM.0000251821.44259.F3. View

Javaherforoosh Zadeh F, Moadeli M, Soltanzadeh M, Janatmakan F . Effect of Remote Ischemic Preconditioning on Troponin I in CABG. Anesth Pain Med. 2018; 7(4):e12549. PMC: 5797663. DOI: 10.5812/aapm.12549. View

Dube K, Ditch K, Hills L . Use of Nebulized Heparin, Nebulized N-Acetylcysteine, and Nebulized Epoprostenol in a Patient With Smoke Inhalational Injury and Acute Respiratory Distress Syndrome. J Pharm Pract. 2016; 30(6):663-667. DOI: 10.1177/0897190016663071. View

Sanguinetti C . N-acetylcysteine in COPD: why, how, and when?. Multidiscip Respir Med. 2016; 11:8. PMC: 4744393. DOI: 10.1186/s40248-016-0039-2. View

Pournajafian A, Ghodraty M, Faiz S, Rahimzadeh P, Goodarzynejad H, Dogmehchi E . Comparing GlideScope Video Laryngoscope and Macintosh Laryngoscope Regarding Hemodynamic Responses During Orotracheal Intubation: A Randomized Controlled Trial. Iran Red Crescent Med J. 2014; 16(4):e12334. PMC: 4028761. DOI: 10.5812/ircmj.12334. View

Neamu R, Martin G . Fluid management in acute respiratory distress syndrome. Curr Opin Crit Care. 2012; 19(1):24-30. DOI: 10.1097/MCC.0b013e32835c285b. View

10.

Herridge M, Tansey C, Matte A, Tomlinson G, Diaz-Granados N, Cooper A . Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011; 364(14):1293-304. DOI: 10.1056/NEJMoa1011802. View

11.

Saguil A, Fargo M . Acute Respiratory Distress Syndrome: Diagnosis and Management. Am Fam Physician. 2020; 101(12):730-738. View

12.

Nasajiyan N, Javaherfourosh F, Ghomeishi A, Akhondzadeh R, Pazyar F, Hamoonpou N . Comparison of low and standard pressure gas injection at abdominal cavity on postoperative nausea and vomiting in laparoscopic cholecystectomy. Pak J Med Sci. 2014; 30(5):1083-7. PMC: 4163237. DOI: 10.12669/pjms.305.5010. View

13.

Piquilloud L, Tassaux D, Bialais E, Lambermont B, Sottiaux T, Roeseler J . Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interaction during non-invasive ventilation delivered by face mask. Intensive Care Med. 2012; 38(10):1624-31. DOI: 10.1007/s00134-012-2626-9. View

14.

Ranieri V, Rubenfeld G, Thompson B, Ferguson N, Caldwell E, Fan E . Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012; 307(23):2526-33. DOI: 10.1001/jama.2012.5669. View

15.

Galvao A, Dornelas de Andrade A, Souza Maia M, Silva K, Bezerra A, Melo J . Antioxidant supplementation for the treatment of acute lung injury: a meta-analysis. Rev Bras Ter Intensiva. 2014; 23(1):41-8. View

16.

Green J, Heard K, Reynolds K, Albert D . Oral and Intravenous Acetylcysteine for Treatment of Acetaminophen Toxicity: A Systematic Review and Meta-analysis. West J Emerg Med. 2013; 14(3):218-26. PMC: 3656701. DOI: 10.5811/westjem.2012.4.6885. View

17.

Chen W, Chen Y, Tsai C, Chen S, Lin M, Ware L . Incidence and Outcomes of Acute Respiratory Distress Syndrome: A Nationwide Registry-Based Study in Taiwan, 1997 to 2011. Medicine (Baltimore). 2015; 94(43):e1849. PMC: 4985407. DOI: 10.1097/MD.0000000000001849. View

18.

Gattinoni L, Quintel M . How ARDS should be treated. Crit Care. 2016; 20:86. PMC: 4822276. DOI: 10.1186/s13054-016-1268-7. View