Tissue oxidative stress level and remote organ injury in two-hit trauma model of sequential burn injury and peritoneal sepsis are attenuated with N-acetylcysteine treatment in rats.

BACKGROUND

The second hit in trauma leads to an exaggerated inflammatory response and multiple organ failure. Infection following burn injury is a useful model for two-hit trauma studies. The aim of this study was to investigate the effect of N-acetylcysteine (NAC) treatment as an antioxidant in a two-hit trauma model.

METHODS

30% scalding burn injury was performed in 45 rats and cecal ligation-puncture (CLP) was performed 72 hours later. Groups were allocated as follows: Group I: No treatment was performed; Group II: Rats were treated with 150 mg/kg/day i.p. NAC for 72 h following CLP; Group III: Rats were treated with 150 mg/kg/day i.p. NAC for 6 days following thermal injury. Tissue samples were collected to study the tissue malonyldialdehyde (MDA) and glutathione (GSH) levels, and for histopathological examination on day 7.

RESULTS

No difference in mortality between groups was detected. Tissue MDA levels significantly decreased in the liver (p=0.01, p=0.02) and ileum (p=0.01, p=0.02) in the treatment groups. Lung tissue GSH levels were found to be significantly increased in Group II (p=0.02). Lung injury scores were decreased in Group II (p=0.005) compared to the control group.

CONCLUSION

NAC attenuated tissue oxidative stress level and remote organ injury in two-hit trauma. Further experimental and clinical studies on this subject are necessary.