1.
The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review.
Fowdar, K, Chen, H, He, Z, Zhang, J, Zhong, X, Zhang, J, Li, M, Bai, J
Heart & lung : the journal of critical care. 2017;(2):120-128
Abstract
N-acetylcysteine (NAC) is an antioxidant and anti-inflammatory. Its effects on chronic obstructive pulmonary (COPD) outcomes, including exacerbation of and changes in lung function parameters, are controversial. To investigate the effects of NAC on COPD exacerbation and changes in lung function parameters in patients with COPD. A meta-analysis of randomized controlled trials retrieved from PubMed and Medline databases (12 trials; 2691 patients). High-dose [relative ratio (RR) = 0.90, 95% confidence interval (CI) = 0.82-0.996, P = 0.041] and low-dose (RR = 0.83, 95% CI = 0.69-0.99, P = 0.043) NAC reduced COPD exacerbation prevalence. Long-term (≥6 months), but not short-term, NAC reduced exacerbation prevalence (RR = 0.85, 95% CI = 0.74-0.98, P = 0.024). NAC did not affect exacerbation rate, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), or inspiratory capacity (IC). Long-term NAC therapy may reduce risk of COPD exacerbation.
2.
Effects of high-dose mucosolvin on lung functions in infant patients with cardiopulmonary bypass.
Zhao, K, Wang, W, Zhang, J, Zhao, R, Chen, T, Su, J, Ma, C, Cui, Q
The heart surgery forum. 2011;(4):E227-31
Abstract
BACKGROUND Cardiopulmonary bypass may cause serious impairment of lung function. It has been reported that administration of mucosolvin can prevent acute respiratory insufficiency through the improvement of pulmonary surfactant. OBJECTIVES This study aimed to explore the effects of high-dose mucosolvin on infant lungs following cardiopulmonary bypass. METHODS One hundred infants were randomly divided into 2 groups. In Group 1, patients did not receive any respiratory drug perioperatively and underwent conventional mechanical ventilation postoperatively. In Group 2, patients were administered mucosolvin (15 mg/kg per day) perioperatively, and doxofylline (15 mg/kg per day) and ipratropium bromide solution (200 μg) were administrated postoperatively. Mechanical ventilation parameters, pulmonary surfactant-related protein (SP-B), and cytokines were evaluated after induction of anesthesia and 30 minutes, 24 hours, and 48 hours after CPB. RESULTS At the end of CPB, all PaO2/FiO2 values in Group 2 were higher than those in Group 1. Postoperative SP-B levels in Group 1 decreased significantly compared to the baseline value (P < .05). There was no significant difference in hospitalization time between both groups, but both mechanical ventilation time and intensive care unit time of infants in Group 2 were significantly shorter than those in group 1 (P < .05). CONCLUSIONS These findings indicate that high-dose mucosolvin has certain protective effects on respiratory functions in infants undergoing heart operations with CPB and that it that has no adverse effects.
3.
Clinical outcomes of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention: a prospective, multicenter, randomized study to analyze the effect of hydration and acetylcysteine.
Chen, SL, Zhang, J, Yei, F, Zhu, Z, Liu, Z, Lin, S, Chu, J, Yan, J, Zhang, R, Kwan, TW
International journal of cardiology. 2008;(3):407-13
Abstract
BACKGROUND The potential role of hydration in prevention of contrast-induced nephropathy (CIN) still remains to be unclear. METHODS Nine-hundred and thirty-six patients scheduled for percutaneous coronary intervention (PCI) were enrolled into the present study, and divided into normal (serum creatinine<1.5 mg/dl) and abnormal (serum creatine> or =1.5 mg/dl) groups according to their baseline serum concentration of creatinine. Each group was further randomly divided into two subgroups: hydration and nonhydration. All patients in abnormal group took twice orally loading dose of 1200 mg acetylcysteine (ATLS) at 12 h before scheduled time for coronary angiogram and immediately after procedure. Creatinine concentration was remeasured at the time of admission (just before catheterization), every day for the following three days. The primary end point during 6-month follow-up included clinical driven revascularization (either PCI or CABG), death from all causes, and requiring emergency renal-replacement therapy. RESULTS The incidence of CIN was more commonly in abnormal group that in normal group (6.52% vs. 37.68%, p<0.001). Hydration had potentials in prevention of CIN only in patients with elevated baseline concentration of creatinine. Multivariate analysis demonstrated that the following variables remained to be significant factors correlating with CIN: age> or =70 years (odds ration [OR] 5.27, 95% confidence interval [CI] 1.94 to 13.07, p=0.0007), contrast volume> or =320 ml (OR 3.26, 95% CL 2.14 to 7.58, p=0.01), diabetes mellitus (OR 9.86, 95% CL 5.38 to 31.67, p<0.0001), and peripheral arterial disease (OR 11.25, 95% CL 5.12 to 43.19, p<0.0001). Patients with CIN in abnormal group had worse clinical outcomes, compared to patients with CIN in normal group. CONCLUSION Patients with CIN and preexisting renal insufficiency had worse clinical outcomes. Hydration with 0.45% sodium chloride alone had no potential effect on the occurrence of CIN in patients with normal renal function. Combination of hydration with ATLS could reduce the incidence of CIN in patients at high risk.