How effective is intravenous N-acetylcysteine for treating critically ill patients with systemic inflammatory response syndrome (SIRS) or sepsis in the intensive care unit (ICU)?

SIRS is a clinical condition that commonly occurs in patients as a result of major trauma, systemic infection, or major surgery.1  SIRS causes massive inflammatory dysfunction involving activation of leukocytes and endothelial cells and the release of inflammatory mediators and toxic oxygen free radicals of intracellular and extracellular origin.1  This mechanism leads to abnormalities in tissue perfusion and tissue hypoxia that result in tissue destruction, multiorgan failure, and death of critically ill patients in the ICU.

Intravenous N-acetylcysteine has been used as an antioxidant defense to prevent damage due to oxygen free radicals in patients with septic shock.1  A systematic review was therefore warranted to determine the effects of using intravenous N-acetylcysteine to treat critically ill patients with SIRS or...

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