الفهرس 
Ischemia Reperfusion InjuryOnly 14 pages are availabe for public view
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Abstract
Background: Despite surgical and pharmacological advances in myocardial protection during CABG, myocardial ischemia reperfusion injury (IRI) still remains the most uncontrolled aspect of cardiac surgeries. The aim of this study is to evaluate the potential effects of intravenous (IV) NAC on myocardial protection against IRI during coronary artery bypass grafting (CABG).
Methods: It’s a prospective, randomized, single blind, placebo-controlled study including two groups of patients, 20 each, with N-group receiving IV NAC bolus dose 100 mg/kg before induction of CPB, followed by infusion of 20 mg/kg/hr until 60 minutes after weaning from CPB, and placebo was given to the other group. All patients underwent uniform pre, intra, post-operative management. All patients were followed by the measurement of cardiac markers (troponin HS) and cardiac enzymes (CK-MB) and observing their hemodynamics. Blood samples were collected before induction of anesthesia, 30 minutes after ACC, and 1, 24, 48 hours postoperatively. Echocardiography and ECG were done postoperatively. Duration of mechanical ventilation and ICU stay were recorded.
Results: There was a significant reduction in the duration of both mechanical ventilation and ICU stay in the N-Group. Measured CK-MB and troponin HS levels in both groups were significantly higher in the postoperative period when compared to the preoperative levels. However, there was a significant reduction in their levels in the N-group after 1 hour postoperatively when compared with the C-Group.
Conclusions: NAC may actually have a role in prevention of myocardial IRI in patients undergoing CABG with cardiopulmonary bypass, by decreasing the oxidative stress at the cellular level.