THE EFFECT OF N-ACETYLCYSTEINE ON TOTAL SERUM ANTIOXIDANT POTENTIAL AND URINARY ALBUMIN EXCRETION IN CRITICALLY ILL PATIENTS

Objective: To investigate the effects of N-acetylcysteine (NAC) when g iven as an early treatment to critically ill patients on the serum tot al anti-oxidant potential (TAP) and urine micro-albumin : creatinine ( M : Cr) ratio. Design: Prospective, placebo controlled, double blinded clinical trial. Setting: General intensive care unit in a teaching ho spital. Patients: Sixty critically ill patients were recruited but ten were withdrawn due to less than 48 h of ICU stay. Interventions: Afte r envelope randomisation, patients received either NAC (n = 23): a bol us of 150 mg/kg in 250 ml of 5% dextrose followed by a continuous infu sion of 12 mg/kg per h in 500 ml of 5% dextrose over 24 h or, as contr ols (n = 27), the equal volume of placebo. Treatment lasted for a mini mum of 3, up to a maximum of 5, days. Blood and urine samples were col lected on admission (0 h) and then 6 hourly up 18 h. Measurements and results: There was no significant difference between NAC and placebo g roups regarding the required length of inotropic support, mechanical v entilation and ICU stay. There was no significant difference in TAP or M : Cr ratio over 18 h or between the groups. Conclusions: Our result s suggest that NAC had no significant effects on the progress of the T AP and the urinary albumin excretion in our patients, which may sugges t that NAC at the given dose has no clinical relevance as an early tre atment in the critically ill.