N-acetylcysteine to Reduce Ischemia/Reperfusion Injury in Liver Resection
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Purpose
Study hypothesis: N-acetylcysteine (NAC) can reduce ischemia/reperfusion injury in liver resection performed under ischemic preconditioning and intermittent portal triad clamping.
| Condition | Intervention | Phase |
|---|---|---|
|
Hepatectomy Reperfusion Injury |
Drug: Acetylcysteine (NAC) Drug: Saline |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | A Randomized Controlled Trial of N-acetylcysteine to Reduce Ischemia/Reperfusion Injury in Liver Resection Performed Under Ischemic Preconditioning and Intermittent Portal Triad Clamping |
- Laboratory results [ Time Frame: 24 hours ] [ Designated as safety issue: No ]Coagulation + cytolysis + cholestasis + lactic acid
- Inflammation [ Time Frame: 24 hours ] [ Designated as safety issue: No ]Cytokines, adhesion molecules (P-selectin and ICAM-1) and nuclear factor kappaB (NF-kappaB). Circulating neutrophils/platelets. Oxidative stress of neutrophils and apoptosis.
| Enrollment: | 46 |
| Study Start Date: | January 2003 |
| Study Completion Date: | December 2007 |
| Primary Completion Date: | October 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: N-acetylcysteine
Intravenous N-acetylcysteine
|
Drug: Acetylcysteine (NAC)
NAC 150 mg/Kg; and infusion of 50 mg/kg, from 30 minutes before the ischemia up to 60 minutes later to the reperfusion
Other Name: Flumil
|
|
Placebo Comparator: Placebo
Placebo
|
Drug: Saline
Na Cl 0.9% infusion
Other Name: Saline
|
Detailed Description:
One of the most important factors in the pathophysiology of liver dysfunction after hepatic surgery is the cellular damage derived from the interruption of blood flood with reperfusion of the organ. N-acetylcysteine (NAC) has proved beneficial in several conditions involving oxidative damage. This study investigates the effects of NAC to reduce ischemia/reperfusion injury in liver resection performed under ischemic preconditioning and intermittent portal triad clamping.
Methods: 46 ASA II-III patients scheduled to undergo liver resection where randomised to receive NAC (initial dose: 150 mg/Kg; and infusion of 50 mg/kg, from 30 minutes before the ischemia up to 60 minutes later to the reperfusion) or placebo in a phase IV clinical trial. Blood, hepatic and urinary markers were obtained at basal status and 1, 3 and 24 h post final reperfusion.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Hepatectomy
Exclusion Criteria:
- ASA 4
- Cirrhosis
- Creatinine > 1.2 mg/dL
- Associate surgery (pancreatic or splenectomy)
- Intraoperative bleeding > 2 L.
- Active infection of inflammatory disease
Contacts and Locations| Spain | |
| Clinica Universidad de Navarra | |
| Pamplona, Navarra, Spain, 31008 | |
| Study Director: | Pablo Monedero, M.D., Ph. D. | Clinica Universidad de Navarra |
More Information
No publications provided
| Responsible Party: | Clinica Universidad de Navarra, Universidad de Navarra |
| ClinicalTrials.gov Identifier: | NCT01223326 History of Changes |
| Other Study ID Numbers: | 2003/NAC, PIUNA |
| Study First Received: | October 15, 2010 |
| Last Updated: | June 7, 2012 |
| Health Authority: | Spain: Spanish Agency of Medicines |
Keywords provided by Clinica Universidad de Navarra, Universidad de Navarra:
|
Acetylcysteine |
Additional relevant MeSH terms:
|
Ischemia Reperfusion Injury Pathologic Processes Vascular Diseases Cardiovascular Diseases Postoperative Complications Acetylcysteine N-monoacetylcystine Antiviral Agents Anti-Infective Agents |
Therapeutic Uses Pharmacologic Actions Expectorants Respiratory System Agents Free Radical Scavengers Antioxidants Molecular Mechanisms of Pharmacological Action Protective Agents Physiological Effects of Drugs Antidotes |
ClinicalTrials.gov processed this record on June 18, 2013