[HSF] Allopurinol references

[psimha]

Yes, I was going to send that.
I think the only subset that may benefit with NAC are those with 
significant hepatic dysfunction and not every case.
Prasanna
DukeB60 at aol.com wrote:
> There is an article in this month's JCVTS about N-acytylcysteine in a  
> randomized trial to assess whether is suppressed the oxidative radicals of  CPB  in 
> patients undergoing CABG with no statistically significant  benefit.  Abstract 
> below:
>  
>  
> Effect of intravenous N-acetylcysteine on outcomes after coronary  artery 
> bypass surgery: A randomized, double-blind, placebo-controlled clinical  trial 
> <NOBR>Ismail El-Hamam,  ,  <NOBR>Louis-Mathieu S, , <NOBR>Michel Car,  ,  
> <NOBR>Michel Pe, , <NOBR>Denis Bouc,  ,  <NOBR>Philippe , , <NOBR>Raymond Car, , 
> <NOBR>Pierre  , , <NOBR>Louis P. Perrault,*  
> Research Center and Department of Surgery, Montreal Heart  Institute and 
> Université de Montréal, Montreal, Quebec, Canada.  
> Received for publication June 8, 2005; revisions received April 25, 2006; 
> accepted for  publication May 24, 2006.  
> * Address for reprints: Louis P.  Perrault, MD, PhD, Montreal Heart 
> Institute, 5000 Bélanger St East, Montréal,  Québec, H1T 1C8, Canada (Email: 
> _louis.perrault at icm-mhi.org_ (mailto:louis.perrault at icm-mhi.org)   ).  
> OBJECTIVE: N-acetylcysteine, a potent anti-inflammatory  and antioxidant 
> agent, is known to decrease the production of  reactive oxygen species after 
> cardiac surgery. The objective of this  study was to evaluate the effects of 
> intravenous  N-acetylcysteine on clinical and biochemical outcomes after  coronary 
> artery bypass surgery with cardiopulmonary bypass.  
> METHODS: One hundred patients (mean age 60.5 years, range 43-78 years, 89% 
> male) undergoing coronary artery bypass grafting at the Montreal Heart Institute 
> were randomized to receive either  N-acetylcysteine (600 mg orally the day 
> before and the morning  of the operation, a bolus of 150 mg/kg of intravenous  
> N-acetylcysteine before skin incision, followed by perfusion  at 12.5 mg · kg–1 
> · h–1 over 24 hours; n = 50)  or placebo (n = 50). The patients and clinical 
> team were blinded to  group assignments. Preoperative characteristics were 
> similar between  the two groups. Postoperative clinical data (death, myocardial  
> infarction, low-output syndromes, arrhythmias, bleeding, transfusion  
> requirements, and intensive care unit and hospital lengths of stay)  and biochemical 
> markers (creatine kinase MB, troponin T, creatinine,  hemoglobin, and platelet 
> levels) were evaluated serially over 4  days.  
> RESULTS: Clinical outcomes were not significantly different between the two 
> groups with regard to the incidence of death, myocardial infarction, bleeding, 
> transfusion requirements, intubation time, and hospital length of stay. No 
> differences were found in  postoperative biochemical markers (troponin T, 
> creatine kinase MB,  creatinine, hemoglobin, and platelets) between the groups. No  
> differences were observed between the groups in interleukin-6  production (P = 
> not significant).  
> CONCLUSIONS: Prophylactic use of N-acetylcysteine in patients  undergoing 
> coronary artery bypass grafting with cardiopulmonary  bypass does not lead to 
> improvement in clinical results or  biochemical markers. Further strategies to 
> decrease reperfusion  injury should be devised. 
>  
> Edward P.  Raines, M.D., J.D.
> BryanLGH Cardiothoracic Surgery
> BryanLGH Medical Center  East
> 1600 South 48th Str.
> Lincoln, Nebraska 68506
> Office:  402-481-8430
> Cell: 402-730-9242
> Fax:  402-481-8429
>   
> ------------------------------------------------------------------------
>
> _______________________________________________
> OpenHeart-L mailing list
>
> Send postings to:
>  OpenHeart-L at lists.hsforum.com
>
> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> http://mmp.cjp.com/mailman/listinfo/openheart-l
>
> All messages transmitted by the OpenHeart-L are subject to the policies and 
> disclaimers posted at:
> http://www.hsforum.com/listdisclaim
> -----------------------------------------
> ------------------------------------------------------------------------
>
> No virus found in this incoming message.
> Checked by AVG Free Edition.
> Version: 7.5.432 / Virus Database: 268.17.4/643 - Release Date: 1/21/2007 5:12 PM
>