The Effect of N-acetyl Cysteine Injection on Liver Function After On-Pump Coronary Artery Bypass Graft Surgery: a Randomized Clinical Trial

Somebody’s organ dysfunctions are associated with the cardiopulmonary bypass in open-heart surgery such as liver dysfunction. This study aimed at the impact of the N-acetyl cysteine for improvement of liver function subsequently on-pump coronary artery bypass graft. Following a clinical trial design, 60 candidates of on-pump CABG, age 30 to 70 years, normal liver function, and normal renal function were selected. The candidates were randomly divided into intervention: IV100 mg/kg N-acetyl cysteine in three doses (2 intraoperative and 1 postoperative) over 24 h, and control groups (normal saline as placebo) (n = 30 in each group). The main outcomes were serum alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, bilirubin, partial thromboplastin time, and the international normalized ratio at first and second postoperative day after surgery. Secondary outcomes were the hemodynamic variables and blood product transfusion. There were significant differences in ALP (P < 0.001), AST (P = 0.02), ALT (P < 0.001), bilirubin (P = 0.01), PTT (P < 0.001), and INR (P = 0.005) levels between the two groups at the first day after surgery. There were significant differences in ALP (P = 0.002), AST (P < 0.001), ALT (P = 0.001), and bilirubin (P = 0.004) levels between the two groups on the second day after surgery. These levels were significantly lower in the N-acetyl cysteine group. Significant differences were observed between the two groups in terms of MAP levels on the first day (P = 0.002) and the second day after surgery (P < 0/001). There was a significant difference between the two groups in terms of packed cell (P = 0.002) and FFP (P < 0.001) transfusion. Based on the findings, intravenous administration of N-acetyl cysteine in patients with CABG significantly may be preserved liver function. Registered under No. Trial registration number IRCT20190506043492N2, date of registration: 2020.05.23. Retrospectively registered.