N-acetylcysteine does not prevent bronchopulmonary dysplasia in immature infants: a randomized controlled trial

Terhi Ahola, Risto Lapatto, Kari O Raivio, Bo Selander, Lennart Stigson, Baldvin Jonsson, Finn Jonsbo, Gitte Esberg, Sören Stövring, Sveinn Kjartansson, Tom Stiris, Kristin Lossius, Kristina Virkola, Vineta Fellman
Journal of Pediatrics 2003, 143 (6): 713-9

OBJECTIVE: To evaluate whether N-acetylcysteine (NAC) infusion during the first week of life reduces the risk of death or bronchopulmonary dysplasia (BPD) in infants with extremely low birth weight. Study design In a Nordic multicenter, double-blind trial, infants (n=391) weighing 500 to 999 g and on ventilator or nasal continuous positive airway pressure were randomized before the age of 36 hours to receive NAC 16 to 32 mg/kg/d (n=194) or placebo (n=197) intravenously for 6 days. Primary end points were death or BPD, defined as supplementary oxygen requirement at 36 weeks' gestational age.

RESULTS: There was no difference in the combined incidence of the primary end points death or BPD, 51% vs. 49%, between the NAC group and control group. Also similar was the incidence of BPD in survivors at 36 weeks' gestational age, 40% vs. 40%, and the mean oxygen requirement at the age of 28 days, 31.2% vs. 30.7%, respectively. The severity of BPD was similar in both groups.

CONCLUSIONS: A 6-day course of intravenous N-acetylcysteine at the dosage used does not prevent BPD or death in infants with extremely low birth weight.

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