EFFECTS OF N-ACETYLCYSTEINE IN ENDOTOXIC-SHOCK

被引：43

作者：

BAKKER, J ^{[1
]}

ZHANG, HB ^{[1
]}

DEPIERREUX, M ^{[1
]}

VANASBECK, S ^{[1
]}

VINCENT, JL ^{[1
]}

机构：

[1] ERASME UNIV HOSP,DEPT INTENS CARE,B-1070 BRUSSELS,BELGIUM

来源：

JOURNAL OF CRITICAL CARE | 1994年 / 9卷 / 04期

关键词：

D O I：

10.1016/0883-9441(94)90003-5

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: The release of oxygen-free radicals has been implicated in both peripheral vascular and myocardial alterations of septic shock. N-Acetylcysteine (N-AC), a substrate for the production of glutathione, has potent antioxidant effects. As a nitrosothiol, it may also improve capillary blood flow. We studied the effects of N-AC in a dog model of endotoxic shock. Methods: Ten pentobarbital anesthetized, mechanically ventilated dogs were randomly assigned to receive either N-AC (150 mg/kg loading dose in 1 hour, followed by 20 mg/kg.h maintenance dose) or D5W. After the loading dose, each dog received 3 mg/kg Escherichia coli endotoxin intravenously. After 30 minutes, saline infusion was started to restore and maintain baseline filling pressures. Results: The loading dose of N-AC increased DO2 significantly (from 661 +/- 54 to 914 +/- 190 mL/min, P < .05), but VO2 remained stable. After the administration of endotoxin, fluid challenge restored cardiac output to baseline, in both groups. Hemoglobin and, thus, DO2 were slightly lower in the N-AC-treated dogs, but VO2 was similar in both groups. At the end of the study, O(2)ER was significantly higher in the N-AC-treated dogs than in the control dogs. Blood lactate levels fell more rapidly in the N-AC dogs than in the control dogs. Blood lactate levels returned to normal in the N-AC dogs but not in the control dogs. Tumor necrosis factor (TNF) also decreased significantly in the N-AC dogs but remained elevated in the control dogs. Conclusion: These data indicate thatN-AC administration in endotoxic shock is well tolerated, may increase oxygen availability to the tissues, and is associated with an attenuation of TNF release. Copyright (C) 1994 by W.B. Saunders Company

引用

页码：236 / 243

页数：8

共 30 条

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