Study objective: To determine whether N-acetylcysteine (NAG) reduces m
ethemoglobin. Methods: We carried out an in vitro laboratory experimen
t in which five healthy adult volunteers donated blood. Each sample wa
s divided equally among three test tubes. Tube 1 served as a negative
control. Sodium nitrite .18 mol/L with dextrose .28 mol/L was added to
tube 2 and to tube 3. Next, phosphate-buffered saline solution (PBS)
was added to tube 2 and NAC (200 mg/mL) to tube 3. Serial methemoglobi
n levels were measured over 5.5 hours. Results: Maximum methemoglobin
levels were observed at 1.5 hours for both the NAC-nitrite and the PBS
-nitrite sample (62.7%+/-8.1% and 65.1%+/-7.0%, respectively; data exp
ressed as mean+/-SD). The mean difference in methemoglobin between NAC
-nitrite and PBS-nitrite was significant at 4.5 hours (29.3%+/-23.0%,
P=.046). The mean rate of methemoglobin decline in NAC-nitrite samples
was also different from that of PBS-nitrite samples (10.7%+/-1.0% ver
sus 2.9%+/-2.3%, P=.002). The rate of decline was linear (zero order)
in the NAC-nitrite samples and represented by the equation: % change m
ethemoglobin =.18 x time in minutes. Area under the concentration-time
curve was also different among groups (P<.05). Conclusion: In this in
vitro model, NAC reduced chemically induced methemoglobin.