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Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis
Acute respiratory distress syndrome (ARDS) is a serious complication of acute lung injury. Severe systemic inflammation is the main cause of multiple organ dysfunction and high mortality. Removal of reactive oxygen species by anti-oxidants has been applied in clinical practice. N-acetylcysteine (NAC...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
D.A. Spandidos
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590037/ https://www.ncbi.nlm.nih.gov/pubmed/28928799 http://dx.doi.org/10.3892/etm.2017.4891 |
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author | Zhang, Ying Ding, Shaoxue Li, Caifeng Wang, Yifeng Chen, Zhe Wang, Zhiqiang |
author_facet | Zhang, Ying Ding, Shaoxue Li, Caifeng Wang, Yifeng Chen, Zhe Wang, Zhiqiang |
author_sort | Zhang, Ying |
collection | PubMed |
description | Acute respiratory distress syndrome (ARDS) is a serious complication of acute lung injury. Severe systemic inflammation is the main cause of multiple organ dysfunction and high mortality. Removal of reactive oxygen species by anti-oxidants has been applied in clinical practice. N-acetylcysteine (NAC) is the most commonly used anti-oxidant. However, the benefit of anti-oxidant therapy was not consistently demonstrated by previous studies. In the present study, a meta-analysis was performed to evaluate the effects of NAC for adult patients with ARDS. The PubMed, Cochrane and EMBASE databases were searched to retrieve all of the available randomized controlled trials (RCTs) published until October 2015. Quality evaluation of included studies was performed according to the modified Jadad scale score. The Cochrane Collaboration Review Manager 5.3 software was used to perform the meta-analysis. Five RCTs comprising 183 patients were found to be eligible for inclusion in the meta-analysis. Pooled analysis showed that NAC did not contribute to reduce short-term mortality [risk ratio (RR)=0.73; 95% confidence interval (CI): 0.50–1.07; P=0.10] or 30-day mortality (RR=0.72; 95% CI: 0.44–1.19; P=0.20) when compared with those in the control group. However, duration of intensive care unit (ICU) stay in the NAC group was shortened [weighted mean difference (WMD), −4.56; 95% CI: (−7.32 to −1.80); P=0.001]. There was no significant difference in the ratio of partial arterial oxygen pressure to the fraction of inspired oxygen between the two groups [WMD, 54.34; 95% CI: (−30.50 to 139.17); P=0.21]. No severe adverse reactions were observed in the patients included. Although the duration of ICU stay was shortened, the clinical benefits of NAC were limited for ARDS based on the present meta-analysis. As the number of included trials and patients was small, additional trials are required to provide sufficient evidence for the efficacy of NAC in ARDS. |
format | Online Article Text |
id | pubmed-5590037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | D.A. Spandidos |
record_format | MEDLINE/PubMed |
spelling | pubmed-55900372017-09-19 Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis Zhang, Ying Ding, Shaoxue Li, Caifeng Wang, Yifeng Chen, Zhe Wang, Zhiqiang Exp Ther Med Articles Acute respiratory distress syndrome (ARDS) is a serious complication of acute lung injury. Severe systemic inflammation is the main cause of multiple organ dysfunction and high mortality. Removal of reactive oxygen species by anti-oxidants has been applied in clinical practice. N-acetylcysteine (NAC) is the most commonly used anti-oxidant. However, the benefit of anti-oxidant therapy was not consistently demonstrated by previous studies. In the present study, a meta-analysis was performed to evaluate the effects of NAC for adult patients with ARDS. The PubMed, Cochrane and EMBASE databases were searched to retrieve all of the available randomized controlled trials (RCTs) published until October 2015. Quality evaluation of included studies was performed according to the modified Jadad scale score. The Cochrane Collaboration Review Manager 5.3 software was used to perform the meta-analysis. Five RCTs comprising 183 patients were found to be eligible for inclusion in the meta-analysis. Pooled analysis showed that NAC did not contribute to reduce short-term mortality [risk ratio (RR)=0.73; 95% confidence interval (CI): 0.50–1.07; P=0.10] or 30-day mortality (RR=0.72; 95% CI: 0.44–1.19; P=0.20) when compared with those in the control group. However, duration of intensive care unit (ICU) stay in the NAC group was shortened [weighted mean difference (WMD), −4.56; 95% CI: (−7.32 to −1.80); P=0.001]. There was no significant difference in the ratio of partial arterial oxygen pressure to the fraction of inspired oxygen between the two groups [WMD, 54.34; 95% CI: (−30.50 to 139.17); P=0.21]. No severe adverse reactions were observed in the patients included. Although the duration of ICU stay was shortened, the clinical benefits of NAC were limited for ARDS based on the present meta-analysis. As the number of included trials and patients was small, additional trials are required to provide sufficient evidence for the efficacy of NAC in ARDS. D.A. Spandidos 2017-10 2017-08-07 /pmc/articles/PMC5590037/ /pubmed/28928799 http://dx.doi.org/10.3892/etm.2017.4891 Text en Copyright: © Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Articles Zhang, Ying Ding, Shaoxue Li, Caifeng Wang, Yifeng Chen, Zhe Wang, Zhiqiang Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis |
title | Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis |
title_full | Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis |
title_fullStr | Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis |
title_full_unstemmed | Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis |
title_short | Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis |
title_sort | effects of n-acetylcysteine treatment in acute respiratory distress syndrome: a meta-analysis |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590037/ https://www.ncbi.nlm.nih.gov/pubmed/28928799 http://dx.doi.org/10.3892/etm.2017.4891 |
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