{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:32:40Z","timestamp":1787776360295,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims and Objectives:<\/jats:title>\n                    <jats:p>The incidence of postoperative liver dysfunction is high in patients undergoing double-valve replacement \u2013 mitral and aortic valve replacement (DVR). This study aims to evaluate N-acetylcysteine\u2019s free radical scavenging property (NAC) to prevent postoperative liver dysfunction in these patients, thus affecting overall clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single-center, prospective, randomized, double-blinded interventional study of 60 patients divided into two groups of 30 each. Group N received prophylactic intravenous NAC, and Group C received volume-matched 5% dextrose. Data comprised demographics, liver function tests (LFT), renal function tests (RFT), vasoactive-inotropic scores (VIS) score, and C-reactive protein (CRP) at various time intervals. Postoperative parameters such as ventilation duration, length of stay in ICU (LOS-ICU), length of hospital stay (LOHS), atrial fibrillation (AF), acute kidney injury (AKI) requiring hemodialysis, and mortality were noted. Statistical analysis was performed with the Student\u2019s t-test and Chi-square test (SPSS 22 software).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All postoperative LFT parameters (total bilirubin, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), and alkaline phosphatase (ALP)) were significantly lower (P &lt; 0.05) at 24, 48, and 72 hours in Group N compared to Group C. RFT and VIS scores were lower in Group N; however, were not statistically significant except for Serum Creatinine at 48 hours (P = 0.0478). Ventilation duration (P = 0.0465) and LOS-ICU (P = 0.0431) were significantly lower in Group N. Other outcomes like AF, LOHS, and mortality were lower in Group N but were not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study showed that prophylactic administration of NAC in patients undergoing DVR is associated with a reduction in the incidence of postoperative liver dysfunction with a positive impact on postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_66_24","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T10:00:57Z","timestamp":1728036057000},"page":"324-329","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Role of Prophylactic N-Acetylcysteine Supplementation on Postoperative Outcomes in Patients Undergoing Elective Double-Valve Replacement (Aortic and Mitral Valve)"],"prefix":"10.4103","volume":"27","author":[{"given":"K S","family":"Ram Kiran","sequence":"first","affiliation":[{"name":"Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital (Medicity Campus), Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visharad","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital (Medicity Campus), Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venuthurupalli S. P.","family":"Rajesh","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital (Medicity Campus), Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital (Medicity Campus), Asarwa, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maruti","family":"Haranal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, UN Mehta Hospital, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himani","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Reaseach, UN Mehta Hospital, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"R1-20241226","first-page":"779","article-title":"Hepatic dysfunction following cardiac surgery: Determinants and consequences","volume":"44","author":"Michalopoulos","year":"1997","journal-title":"Hepatogastroenterology"},{"key":"R2-20241226","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/108925320400800306","article-title":"Abdominal organ injury after cardiac surgery","volume":"8","author":"Hessel","year":"2004","journal-title":"Semin Cardiothorac Vasc Anesth"},{"key":"R3-20241226","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.bpa.2015.04.001","article-title":"Hepatic and renal effects of cardiopulmonary bypass","volume":"29","author":"Di Tomasso","year":"2015","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"R4-20241226","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1097\/00000542-200211000-00046","article-title":"Hepatic failure after cardiopulmonary bypass is unlikely to be isoflurane hepatitis","volume":"97","author":"Wark","year":"2002","journal-title":"Anesthesiology"},{"key":"R5-20241226","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ejcts.2008.11.027","article-title":"Use of N-acetylcysteine to reduce post-cardiothoracic surgery complications: A meta-analysis","volume":"35","author":"Baker","year":"2009","journal-title":"Eur J Cardiothorac Surg"},{"key":"R6-20241226","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1080\/08941939.2016.1269853","article-title":"Efficacy of N-Acetylcysteine in preventing acute kidney injury after cardiac surgery: A meta-analysis study","volume":"31","author":"Mei","year":"2018","journal-title":"J Invest Surg"},{"key":"R7-20241226","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S1010-7940(99)00134-7","article-title":"European system for cardiac operative risk evaluation (EuroSCORE)","volume":"16","author":"Nashef","year":"1999","journal-title":"Eur J Cardiothorac Surg"},{"key":"R8-20241226","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/icvts\/ivu409","article-title":"Use of a novel vasoactive-ventilation-renal score to predict outcomes after paediatric cardiac surgery","volume":"20","author":"Miletic","year":"2015","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R9-20241226","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.4065\/81.9.1232","article-title":"Hypoxic liver injury","volume":"81","author":"Ebert","year":"2006","journal-title":"Mayo Clin Proc"},{"key":"R10-20241226","first-page":"263","article-title":"Hypoxic hepatitis: A review and clinical update","volume":"4","author":"Waseem","year":"2016","journal-title":"J Clin Transl Hepatol"},{"key":"R11-20241226","doi-asserted-by":"crossref","first-page":"460","DOI":"10.5152\/TJAR.2021.21370","article-title":"N-acetylcysteine supplementation for the prevention of postoperative liver dysfunction after on-pump cardiac surgery","volume":"49","author":"Kumar","year":"2021","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R12-20241226","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1053\/j.jvca.2018.02.037","article-title":"Liver dysfunction in cardiac surgery - 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