The Effect of N-acetylcysteine in Prime Solution on Reducing Damage to the Myocardium in Open Heart Surgery

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc in Circulatory Technology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/jims.v41.i749.1140

Abstract

Background: Cardiopulmonary bypass and reperfusion injury lead to the release of free radicals and inflammatory mediators during surgery. The use of antioxidants during cardiopulmonary bypass has become a strategy to save the myocardium from the attack of these radicals. This study aimed to investigate the effect of N-acetyl cysteine on reducing damage to the myocardium caused by free radicals.
Methods: In a randomized clinical trial, 40 patients who were candidates for vascular graft surgery to receive
N-acetyl cysteine in Prime solution were randomly divided into two intervention and control groups. In the intervention group, N-acetyl cysteine was added to the prime solution, and in the control group, an equivalent volume of placebo (normal saline) was administered. The levels of Troponin I and C-reactive protein, the need for shock and pacemaker, and the length of stay in the Intensive Care Unit were investigated and compared in both groups.
Findings: The patients of both groups did not have significant differences in terms of ages, sex, ejection fraction, duration of the pump, and Athort clamp. Average troponin 8 hours after surgery in the intervention and control groups were 60.5 ± 1.84 and 5.05 ± 1.84 respectively. 10.37 ± 1.0 and the average CRP 24 hours after the operation was 28.47 ± 7.45 and 55.18 ± 5.74, respectively. The need for a defibrillator was not significantly different between the two groups (P < 0.05). The average length of stay in the intensive care unit in the intervention and control groups was 51.73 ± 10.9 and 55.78 ± 13.5, respectively, and no significant difference was seen.
Conclusion: The results show that the use of NAC decreases CRP and cTnI after open heart surgery, which shows its antioxidant and anti-inflammatory effect on the myocardium.

Highlights

Mehran Shahzamani: Google Scholar, PubMed

Alireza Hoseini: Google Scholar, PubMed

Keywords

Main Subjects

References

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Journal of Isfahan Medical School
Volume 41, Issue 749
1st Week, March
March and April 2024
Pages 1140-1146

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