The Pharmacokinetic Profile and Bioavailability of Enteral N-Acetylcysteine in Intensive Care Unit

<i>Background and Objectives</i>: N-acetylcysteine (NAC) is a mucolytic agent used to prevent ventilator-associated pneumonia in intensive care units. This study aimed to evaluate the oral bioavailability of NAC in critically ill patients with pneumonia, isolated acute brain injury and a...

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Auteurs principaux: Kersti Teder, Liivi Maddison, Hiie Soeorg, Andres Meos, Juri Karjagin
Format: article
Langue:EN
Publié: MDPI AG 2021
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Accès en ligne:https://doaj.org/article/fcbf4b7f10cc4fa5ba0745f2073af60d
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Résumé:<i>Background and Objectives</i>: N-acetylcysteine (NAC) is a mucolytic agent used to prevent ventilator-associated pneumonia in intensive care units. This study aimed to evaluate the oral bioavailability of NAC in critically ill patients with pneumonia, isolated acute brain injury and abdominal sepsis. <i>Materials and Methods</i>: This quantitative and descriptive study compared NAC’s pharmacokinetics after intravenous and enteral administration. 600 mg of NAC was administered in both ways, and the blood levels for NAC were measured. <i>Results</i>: 18 patients with pneumonia, 19 patients with brain injury and 17 patients with abdominal sepsis were included in the population pharmacokinetic modelling. A three-compartmental model without lag-time provided the best fit to the data. Oral bioavailability was estimated as 11.6% (95% confidence interval 6.3–16.9%), similar to bioavailability in healthy volunteers and patients with chronic pulmonary diseases. <i>Conclusions</i>: The bioavailability of enteral NAC of ICU patients with different diseases is similar to the published data on healthy volunteers.