eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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3/2009
vol. 5
 
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abstract:

Clinical research
Effect of N-acetylcysteine on microalbuminuria in patients with acute respiratory distress syndrome

Atabak Najafi
,
Mojtaba Mojtahedzadeh
,
Ata Mahmoodpoor
,
Mostafa Aghamohammadi
,
Arezou Ahmadi
,
Sheida Nahreini
,
Marzieh Pazuki
,
Mohammad Reza Khajavi
,
Mohammad Abdollahi

Arch Med Sci 2009; 5, 3: 408-414
Online publish date: 2009/10/22
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Introduction: Acute respiratory distress syndrome (ARDS) is associated with enlarged permeability of respiratory capillaries resulting in interstitial edema and microalbuminuria. This study investigated the effect of early treatment with N-acetylcysteine (NAC) on microalbuminuria/creatinine ratio and clinical improvement in ARDS.
Material and methods: Twenty-three patients with ARDS were randomly entered into two groups of study including regular therapy and regular therapy plus NAC. NAC was started with 150 mg/kg on the first day followed by 50 mg/kg at the second day. Urine sample was tested for microalbuminuria on 4, 6, 12, 24, 36, and 48 h post baseline.
Results: No significant correlation was found between microalbumin/creatinine ratio (MACR) and acute physiology and chronic health evaluation (APACHE II) or PaO2/FiO2 ratio and blood pressure in each group. Non-survivors showed higher urine albumin creatinine ratio (ACR) and physiologic scores than survivors. The patients outcome who treated with NAC showed significant improvement comparing with controls.
Conclusions: NAC improves global hypoxemia in the patients with acute lung injury. Improvement of oxidant/antioxidant balance by NAC increases the survival of patients with ARDS who are under oxidative crisis. Although limitations of this study do not let us to reach a conclusive decision but the impact of microalbominuria as a predictive of survival in ARDS patients receiving NAC seems essential. Conducting larger clinical trials are recommended.
keywords:

N-acetylcysteine, acute respiratory distress syndrome, microalbuminuria

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