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



Shahzamani M¹ ; Hoseini A¹ ; Baharifar B² Show Affiliations
Source: Journal of Isfahan Medical School Published:2024

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. © 2024 Isfahan University of Medical Sciences(IUMS). All rights reserved.