tailieunhanh - Báo cáo y học: " NAC: still the way to go"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: NAC: still the way to go. | Available online http content 13 3 411 Letter NAC still the way to go Amit K Gupta Gar M Chan Howard A Greller and Mark K Su Department of Emergency Medicine North Shore University Hospital 300 Community Drive Manhasset NY 11030 USA Corresponding author Amit K Gupta agupta1@ Published 18 June 2009 This article is online at http content 13 3 411 2009 BioMed Central Ltd See related research by Yang et al. http content 13 2 R55 We would like to thank Yang and colleagues for their attempt to determine the possibility of delayed hepatic recovery with N-acetylcysteine NAC administration in acetaminophen-induced hepatotoxicity 1 . We are concerned however about the possible consequences that may arise from their conclusions. Owing to the wide availability of acetaminophen intentional and unintentional overdoses are one of the leading causes of liver failure in the world 2 . NAC is currently a highly effective and safe antidote to treat acute acetaminophen overdose and is most efficacious when administered within 8 hours of ingestion 3 . Furthermore one landmark study showed that even in patients who presented with delayed acetaminopheninduced fulminant hepatic failure intravenous NAC administration improved survival versus control individuals 48 vs. 20 4 . Another study found that the infusion of acetyl- Critical Care 2009 13 411 doi ee7905 cysteine in patients with acetaminophen-induced liver failure resulted in an increase in mean oxygen delivery and in an increased mean arterial pressure 5 . It is difficult to believe that the mouse model of Yang and colleagues has any correlation to humans since the already established human data are so overwhelmingly positive. The amount of acetaminophen administered in their study caused hepatotoxicity but did not induce death and therefore is not applicable to real-life situations where people may ingest potentially fatal doses of acetaminophen. It is not clear to us why the .