Abstract
Objective: To determine the levels of glutathione and cysteine in patients with ARDS and examine the effect of treatment with N-acetylcysteine (NAC) and L-2-oxothiazolidine-4-carboxylate (Procysteine; Clintec Technologies Inc; Chicago [OTZ]) on these levels and on common physiologic abnormalities, and organ dysfunction associated with ARDS. Design: Randomized, double-blind, placebo-controlled, prospective clinical trial. Setting: ICUs in five clinical centers in the United States and Canada. Patients: Patients meeting a predetermined definition of ARDS and requiring mechanical ventilation. Intervention: Standard care for AIDS and IV infusion, every 8 h for 10 days, of one of the following: NAC (70 mg/kg, n=14), OTZ (63 mg/kg, n=17), or placebo (n=15). Main results: Both antioxidants effectively repleted RBC glutathione gradually over the 10-day treatment period (47% and 49% increases from baseline values for NAC and OTZ, respectively). There was no difference in mortality among groups (placebo, 40%; NAC, 36%; OTZ, 35%). However, the number of days of acute lung injury was decreased and there was also a significant increase in cardiac index in both treatment groups (NAC/OTZ [+]14%; placebo [-]6%). Conclusions: Our findings suggest that repletion of glutathione may safely be accomplished with NAC or OTZ in patients with acute lung injury/ARDS. Such treatment may shorten the duration of acute lung injury, but larger studies are needed to confirm this.
Original language | English |
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Pages (from-to) | 164-172 |
Number of pages | 9 |
Journal | Chest |
Volume | 112 |
Issue number | 1 |
DOIs | |
State | Published - 1997 |
Keywords
- ARDS
- Antioxidants
- Cysteine
- Glutathione
- Lung injury
- N- acetylcysteine
- Oxothiazolidine-carboxylate
- Procysteine
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine