N-Acetylcysteine for Sepsis and Systemic Inflammatory Response in Adults

Abstract

©2013 American Association of Critical-Care Nurses doi: http://dx.doi.org/10.4037/ccn2013699 Study Description and Interventions This is the summary of a Cochrane systematic review. Only randomized controlled trials (RCTs) were eligible for inclusion in the review; cross-over or quasi-randomization designs were excluded. Participants were patients with SIRS or sepsis, irrespective of their underlying illness. SIRS and sepsis were assessed according to the criteria established by Bone et al. Interventions were as follows: N-acetylcysteine in bolus intravenous doses or as a continuous infusion or a combination of both. The review also included studies wherein intravenous N-acetylcysteine was compared with placebo or was used as a standard treatment. The dose of N-acetylcysteine varied from 25 mg/kg to 150 mg/kg across studies, and the timing and duration of N-acetylcysteine treatment varied from a single bolus dose to infusion up to 7 days. The primary outcome of interest was 30-day all-cause mortality. Secondary outcomes included length of stay in the ICU, duration of mechanical ventilation, duration of inotropic Review Question How effective is intravenous N-acetylcysteine for treating critically ill patients with systemic inflammatory response syndrome (SIRS) or sepsis in the intensive care unit (ICU)?