Effect of N-acetylcystein on pulmonary function in patients undergoing off-pump coronary artery bypass surgery

Younglan Kwak, J. C. Kim, S. W. Hong, J. K. Shim, K. J. Yoo, D. H. Chun

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Pulmonary dysfunction related to inflammatory response and radical oxygen species remains a problem in off-pump coronary bypass graft surgery (OPCAB), especially in patients with reduced left ventricular (LV) function. The aim of this study was to evaluate the effect of N-acetylcystein (NAC) on pulmonary function following OPCAB. Methods: Patients with LV ejection fraction ≤ 40% were randomly assigned to receive either a bolus of 100mg/kg of intravenous NAC over a 15-min period immediately after anesthetic induction, followed by an intravenous infusion at 40mg/kg/day for 24h (NAC group, n = 24), or a placebo (control group, n = 24). Hemodynamic and pulmonary parameters, and the incidence of acute lung injury (PaO2/ FiO2<300mmHg) were assessed and compared. Results: The pulmonary vascular resistance index (PVRI) did not change during mechanical heart displacement compared with the baseline value in the NAC group while it was significantly increased in the control group. Significantly less number of patients developed acute lung injury at 2 h after the surgery in the NAC group. The other pulmonary parameters and the duration of ventilator care were all similar. Conclusions: NAC demonstrated promising results in terms of mitigating the increase in PVRI during mechanical heart displacement and attenuating the development of acute lung injury in the immediate post-operative period. However, NAC could not induce a definite improvement in the other important pulmonary variables including PaO 2/FiO2 and Qs/Qt, and did not lead to a decreased duration of ventilatory care or length of stay in the intensive care unit.

Original languageEnglish
Pages (from-to)452-459
Number of pages8
JournalActa Anaesthesiologica Scandinavica
Volume55
Issue number4
DOIs
Publication statusPublished - 2011 Apr 1

Fingerprint

Off-Pump Coronary Artery Bypass
Coronary Artery Bypass
Acute Lung Injury
Lung
Vascular Resistance
Transplants
Control Groups
Mechanical Ventilators
Left Ventricular Function
Intravenous Infusions
Stroke Volume
Intensive Care Units
Anesthetics
Reactive Oxygen Species
Length of Stay
Hemodynamics
Placebos
Incidence

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Kwak, Younglan ; Kim, J. C. ; Hong, S. W. ; Shim, J. K. ; Yoo, K. J. ; Chun, D. H. / Effect of N-acetylcystein on pulmonary function in patients undergoing off-pump coronary artery bypass surgery. In: Acta Anaesthesiologica Scandinavica. 2011 ; Vol. 55, No. 4. pp. 452-459.
@article{f109495654184796a6c4330e69d8c5a7,
title = "Effect of N-acetylcystein on pulmonary function in patients undergoing off-pump coronary artery bypass surgery",
abstract = "Background: Pulmonary dysfunction related to inflammatory response and radical oxygen species remains a problem in off-pump coronary bypass graft surgery (OPCAB), especially in patients with reduced left ventricular (LV) function. The aim of this study was to evaluate the effect of N-acetylcystein (NAC) on pulmonary function following OPCAB. Methods: Patients with LV ejection fraction ≤ 40{\%} were randomly assigned to receive either a bolus of 100mg/kg of intravenous NAC over a 15-min period immediately after anesthetic induction, followed by an intravenous infusion at 40mg/kg/day for 24h (NAC group, n = 24), or a placebo (control group, n = 24). Hemodynamic and pulmonary parameters, and the incidence of acute lung injury (PaO2/ FiO2<300mmHg) were assessed and compared. Results: The pulmonary vascular resistance index (PVRI) did not change during mechanical heart displacement compared with the baseline value in the NAC group while it was significantly increased in the control group. Significantly less number of patients developed acute lung injury at 2 h after the surgery in the NAC group. The other pulmonary parameters and the duration of ventilator care were all similar. Conclusions: NAC demonstrated promising results in terms of mitigating the increase in PVRI during mechanical heart displacement and attenuating the development of acute lung injury in the immediate post-operative period. However, NAC could not induce a definite improvement in the other important pulmonary variables including PaO 2/FiO2 and Qs/Qt, and did not lead to a decreased duration of ventilatory care or length of stay in the intensive care unit.",
author = "Younglan Kwak and Kim, {J. C.} and Hong, {S. W.} and Shim, {J. K.} and Yoo, {K. J.} and Chun, {D. H.}",
year = "2011",
month = "4",
day = "1",
doi = "10.1111/j.1399-6576.2011.02407.x",
language = "English",
volume = "55",
pages = "452--459",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Blackwell Munksgaard",
number = "4",

}

Effect of N-acetylcystein on pulmonary function in patients undergoing off-pump coronary artery bypass surgery. / Kwak, Younglan; Kim, J. C.; Hong, S. W.; Shim, J. K.; Yoo, K. J.; Chun, D. H.

In: Acta Anaesthesiologica Scandinavica, Vol. 55, No. 4, 01.04.2011, p. 452-459.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of N-acetylcystein on pulmonary function in patients undergoing off-pump coronary artery bypass surgery

AU - Kwak, Younglan

AU - Kim, J. C.

AU - Hong, S. W.

AU - Shim, J. K.

AU - Yoo, K. J.

AU - Chun, D. H.

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Background: Pulmonary dysfunction related to inflammatory response and radical oxygen species remains a problem in off-pump coronary bypass graft surgery (OPCAB), especially in patients with reduced left ventricular (LV) function. The aim of this study was to evaluate the effect of N-acetylcystein (NAC) on pulmonary function following OPCAB. Methods: Patients with LV ejection fraction ≤ 40% were randomly assigned to receive either a bolus of 100mg/kg of intravenous NAC over a 15-min period immediately after anesthetic induction, followed by an intravenous infusion at 40mg/kg/day for 24h (NAC group, n = 24), or a placebo (control group, n = 24). Hemodynamic and pulmonary parameters, and the incidence of acute lung injury (PaO2/ FiO2<300mmHg) were assessed and compared. Results: The pulmonary vascular resistance index (PVRI) did not change during mechanical heart displacement compared with the baseline value in the NAC group while it was significantly increased in the control group. Significantly less number of patients developed acute lung injury at 2 h after the surgery in the NAC group. The other pulmonary parameters and the duration of ventilator care were all similar. Conclusions: NAC demonstrated promising results in terms of mitigating the increase in PVRI during mechanical heart displacement and attenuating the development of acute lung injury in the immediate post-operative period. However, NAC could not induce a definite improvement in the other important pulmonary variables including PaO 2/FiO2 and Qs/Qt, and did not lead to a decreased duration of ventilatory care or length of stay in the intensive care unit.

AB - Background: Pulmonary dysfunction related to inflammatory response and radical oxygen species remains a problem in off-pump coronary bypass graft surgery (OPCAB), especially in patients with reduced left ventricular (LV) function. The aim of this study was to evaluate the effect of N-acetylcystein (NAC) on pulmonary function following OPCAB. Methods: Patients with LV ejection fraction ≤ 40% were randomly assigned to receive either a bolus of 100mg/kg of intravenous NAC over a 15-min period immediately after anesthetic induction, followed by an intravenous infusion at 40mg/kg/day for 24h (NAC group, n = 24), or a placebo (control group, n = 24). Hemodynamic and pulmonary parameters, and the incidence of acute lung injury (PaO2/ FiO2<300mmHg) were assessed and compared. Results: The pulmonary vascular resistance index (PVRI) did not change during mechanical heart displacement compared with the baseline value in the NAC group while it was significantly increased in the control group. Significantly less number of patients developed acute lung injury at 2 h after the surgery in the NAC group. The other pulmonary parameters and the duration of ventilator care were all similar. Conclusions: NAC demonstrated promising results in terms of mitigating the increase in PVRI during mechanical heart displacement and attenuating the development of acute lung injury in the immediate post-operative period. However, NAC could not induce a definite improvement in the other important pulmonary variables including PaO 2/FiO2 and Qs/Qt, and did not lead to a decreased duration of ventilatory care or length of stay in the intensive care unit.

UR - http://www.scopus.com/inward/record.url?scp=79952593901&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952593901&partnerID=8YFLogxK

U2 - 10.1111/j.1399-6576.2011.02407.x

DO - 10.1111/j.1399-6576.2011.02407.x

M3 - Article

VL - 55

SP - 452

EP - 459

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 4

ER -