Chest
Clinical Investigations: MiscellaneousN-Acetylcysteine Enhances Recovery From Acute Lung Injury in Man: A Randomized, Double-Blind, Placebo-Controlled Clinical Study
Section snippets
Subjects and Protocol
During a 12-month period, patients with risk factors known to predispose to the development of ARDS (see below), and presenting with mild-to-moderate acute lung injury, were included in the trial in the four participating intensive care units (ICUs) in Switzerland (Geneva, Lausanne, Basel, Locarno).
In order to collect patients with comparable lung dysfunction for a pharmacologic treatment regimen, we used the expanded definition suggested by Murray et al,22 and only considered patients
Characterization of Patients
A total of 61 patients (47 men and 14 women) were recruited for the study (Table 1). All were considered evaluable for data analysis. Thirty-two patients received NAC and 29 received placebo. The two groups were well matched for demographic characteristics on trial entry. The SAPS for severity of disease26 was 10.8 ± 4.6 in the NAC group and 10.9 ± 4.8 in the placebo group (x ± SD, not significant [NS]). On admission, the lung injury score22 was 1.39 ± 0.95 in the NAC group, a value not
Discussion
Despite major improvements in patient care, ARDS still remains a formidable clinical challenge and carries a high mortality rate.27 Recent clinical studies suggest that patients with ARDS undergo relevant oxidative stress.12, 13, 14,16,19,28 Toxic oxygen products cause cellular and subcellular damage and activate epithelial cells, macrophages, or endothelial cells. Oxygen radicals are also recognized as mediators between primary and secondary effectors, either directly or via cytokine release (
ACKNOWLEDGMENTS
We would express our thanks to R. Ruffmann, M.D., Head of the Medical Division of Inpharzam SA, Zambon Group, for stimulating discussions and collaboration, and to G. Krejci, Ph.D., Clinical Investigations, Ltd, London, U.K., for the statistical analysis.
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