Improved outcome of paracetamol-induced fulminant hepatic failure by late administration of acetylcysteine

✍ Scribed by Harrison, P.M.; Keays, R.; Bray, G.P.; Alexander, G.J.M.; Williams, R.

• Book ID: 122841987
• Publisher: The Lancet
• Year: 1990
• Tongue: English
• Weight: 301 KB
• Volume: 335
• Category: Article
• ISSN: 0140-6736
• DOI: 10.1016/0140-6736(90)91388-Q

✦ Synopsis

The influence of acetylcysteine, administered at presentation to hospital, on the subsequent clinical course of 100 patients who developed paracetamol-induced fulminant hepatic failure was analysed retrospectively. Mortality was 37% in patients who received acetylcysteine 10-36 h after the overdose, compared with 58% in patients not given the antidote. In patients given acetylcysteine, progression to grade III/IV coma was significantly less common than in those who did not receive the antidote (51% vs 75%), although the median peak prothrombin time was similar for both groups. Whether the beneficial effect is related to replenishment of glutathione stores or a consequence of another hepatic protective mechanism of acetylcysteine requires further study.