In this episode, I’ll discuss whether N-acetylcysteine can be used in non-acetaminophen-induced acute liver failure.
A prospective study of 80 patients of Kashmiri ethnicity with non-acetaminophen-induced acute liver failure was published in 2017 where half of the patients received a 72-hour infusion of IV N-acetylcysteine (NAC )and half served as controls.
Baseline characteristics between groups were similar with the exception of age, which was slightly higher in the control group.
The mortality decreased to 28% with the use of NAC versus 53% in the control group, and this was statistically significant. In addition to improvements in survival, the NAC group was discharged faster.
Patients with drug-induced acute liver failure as the cause of liver failure also were found to have improved outcomes with NAC.
No adverse effect was noted in patients in the NAC group, which could have been attributed to NAC administration.
This study confirms the practice of giving NAC to patients with non-acetaminophen-induced acute liver failure, especially if it is drug-induced.
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