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Evaluation of nebulized N-acetyl cysteine in outcome of esophageal atresia with tracheoesophegeal fistula.
Singh, Gurmeet; Pandey, Anand; Shandilya, Gaurav; Gupta, Archika; Rawat, J D; Wakhlu, Ashish; Kureel, S N.
Afiliación
  • Singh G; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
  • Pandey A; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India. Electronic address: dranand27@rediffmail.com.
  • Shandilya G; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
  • Gupta A; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
  • Rawat JD; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
  • Wakhlu A; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
  • Kureel SN; Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
J Pediatr Surg ; 55(12): 2635-2639, 2020 Dec.
Article en En | MEDLINE | ID: mdl-32467034
AIM: To evaluate the role of nebulized N-acetyl cysteine (NAC) in liquefying the airway secretions and improving the outcome of patients of esophageal atresia with tracheoesophageal fistula (EA + TEF). METHODS: It was a non-randomized interventional study. Two milliliters of 10% NAC was given in a nebulized form (2:5 dilution, every six hourly) to patients of ET + TEF, along with regular suction of upper esophageal pouch. The group was compared with control, which comprised patients of EA + TEF receiving only saline nebulization. The consistency of the secretions was compared by hand held consistometer in unit of time (seconds) required to cross a predetermined distance along with gravity. RESULTS: Sixty patients were assessed. Of these, 30 patients were present in both groups. The study group showed significant (p = 0.01-0.0001) decrease in consistency of secretions from the control group after day 2 of NAC nebulization. Patients' discharge was significantly (p = 0.01) earlier in cases. There was no significant (p = 0.41) difference in mortality between the groups. No specific adverse effects were observed in the study group. CONCLUSION: It appears that nebulized NAC decreases the consistency of secretions in EA + TEF patients. It is interesting to note that the group of patients that received NAC was discharged earlier than the control group and had a higher survival rate than the control group. Whether this is directly attributable to the use of NAC is unknown. A prospective double-blinded randomized clinical trial is warranted to confirm these results. LEVEL OF EVIDENCE: Level II, prospective comparative study (non-randomized).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acetilcisteína / Fístula Traqueoesofágica / Atresia Esofágica Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Pediatr Surg Año: 2020 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Acetilcisteína / Fístula Traqueoesofágica / Atresia Esofágica Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Pediatr Surg Año: 2020 Tipo del documento: Article País de afiliación: India Pais de publicación: Estados Unidos