الفهرس 
• Pathophysiology and Risk FactorsOnly 14 pages are availabe for public view
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Abstract
Potential Protective Effect of N-Acetyl Cysteine on Renal Function during Cardiopulmonary Bypass in comparison to Manitol
Amir Salah MD; Ayman M Kamaly MD; Hadil Magdy MD Mohamed Elgohary; Msc
ABSTRACT
Introduction Acute renal failure (ARF) occurring around the time of surgery is a serious complication associated with considerable morbidity and mortality. A Patients undergoing cardiac surgery are at particular risk of developing Acute Renal Failure (ARF) that commonly results in a poor outcome appropriate perioperative strategies are required to protect renal function to optimize patient outcome. Because cardiopulmonary bypass and cardioplegic arrest are associated with formation of free radicals, which have been shown to impair various organs including the kidneys, radical scavenging may protect renal function. (Hertzer et al., 2002).
Therefore, the purpose of our study was to evaluate the impact of the radical scavenger N-acetylcysteine (NAC) versus Mannitol on peri-operative renal function in cardiac surgery patients.
Patients and methods: This study was conducted on (63) adult patients in the department of Anesthesia and Intensive care, in intensive care unit, Ain Shams University undergoing elective cardiac surgery, Patients were randomly allocated into one of three groups, group (N) (n=21) received N-acetyl cysteine oral dose of (1800 mg ) in the preoperative night and another (1800 mg) pre-bypass , group (M) (n=21) received Mannitol during (CPB) as an IV dose of (0.5 mg/kg) and group (C) (n=21) as a control group received neither drugs , afterwards renal function was measured using serum creatinine and cystatin C, comparing the three groups.
Results: Biometric and intra-operative patient data were similar between groups. our study showed that the administration of N-acetyl cysteine as well as the Mannitol prevented the rise of serum creatinine in the post CPB period when compared to the control group. In group (N) serum cr rose from0.75±0.18 to 0.82±0.20 , in group (M) serum cr rose from0.70±0.15 to0.95±0.25 in group (C) serum cr rose from0.73±0.17 to 1.20±0.28.
Conclusion: The use of n acetyl cysteine may play a reno-protective role during on pump cardiac surgery which could be attributed to its antioxidant effect.
References:
Fisher UM, Tossios P, Mehlhorn U: Renal protection by radical scavenging in cardiac surgery patients. Curr Med Res Opin (2005); 8: 1161–1164
Hertzer NR, Mascha EJ, Karafa MT, et al. Open infrarenal abdominal aortic aneurysm repair: the Cleveland Clinic experience from 1989 to 1998. J Vasc Surg 2002; 35:1145–54.