• Intensive care medicine · Sep 1998

    Influence of N-acetylcysteine treatment on endotoxin-induced microcirculatory disturbances.

    • W Schmidt, A Walther, M M Gebhard, E Martin, and H Schmidt.
    • Department of Anesthesiology, University of Heidelberg, Germany. werner.schmidt@urz.uni-heidelberg.de
    • Intensive Care Med. 1998 Sep 1; 24 (9): 967972967-72.

    ObjectivesTo determine the influence of N-acetylcysteine (NAC) in a treatment model, its effects on endotoxin-induced leukocyte-endothelial cell adhesion, vascular leakage, and venular microhemodynamics in postcapillary venules of rat mesentery.DesignProspective, randomized, controlled, experimental study.SettingAnimal research laboratory.Subjects40 male Wistar rats.InterventionsThe rats randomly received one of four treatments: infusion of saline (SAL) or Escherichia coli lipopolysaccharides (LPS) followed by treatment with saline (SAL) or NAC (150 mg.kg-1 body weight) 30 min after induction of endotoxemia.Measurements And Main ResultsLeukocyte adherence, red blood cell velocity, and vessel diameters in postcapillary venules of rat mesentery were evaluated every 30 min over a period of 120 min using in vivo videomicroscopy. Vascular permeability was determined by measuring the extravasation of fluorescence-labeled albumin. Venular wall shear rate was calculated from red cell velocity, and vessel diameter. NAC in rats without endotoxemia (SAL + NAC group) compared to the control group (SAL + SAL) did not change microcirculatory parameters in postcapillary venules of rat mesentery. In both LPS-treated groups (LPS + SAL and LPS + NAC), leukocyte adherence increased after just 30 min. NAC treatment prevented a further increase in leukocyte adherence and attenuated the extravasation of fluorescence-labeled albumin during endotoxemia. Venular diameters remained unchanged, while erythrocyte velocity decreased in the LPS + SAL group. This led to a lower venular wall shear rate in this group.ConclusionsTreatment with NAC attenuates endotoxin-induced leukocyte adherence and macromolecular leakage in postcapillary venules of rat mesentery, showing that NAC is also effective after the onset of endotoxemia.

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