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N-acetylcysteine protects striated muscle in a model of compartment syndrome.

Abstract：

BACKGROUND:To avoid ischemic necrosis, compartment syndrome is a surgical emergency treated with decompression once identified. A potentially lethal, oxidant-driven reperfusion injury occurs after decompression. N-acetylcysteine is an antioxidant with the potential to attenuate the reperfusion injury. QUESTIONS/PURPOSES:We asked whether N-acetylcysteine could preserve striated muscle contractility and modify neutrophil infiltration and activation after simulated compartment syndrome release. MATERIALS AND METHODS:Fifty-seven rats were randomized to control, simulated compartment syndrome, and simulated compartment syndrome plus N-acetylcysteine groups. We isolated the rodent cremaster muscle on its neurovascular pedicle and placed it in a pressure chamber. Chamber pressure was elevated above critical closing pressure for 3 hours to simulate compartment syndrome. Experiments were concluded at three times: 1 hour, 24 hours, and 7 days after decompression of compartment syndrome. We assessed twitch and tetanic contractile function and tissue myeloperoxidase activity. Ten additional rats were randomized to control and N-acetylcysteine administration after which neutrophil respiratory burst activity was assessed. RESULTS:The simulated compartment syndrome decreased muscle contractility and increased muscle tissue myeloperoxidase activity compared with controls. Treatment with N-acetylcysteine preserved twitch and tetanic contractility. N-acetylcysteine did not alter neutrophil infiltration (myeloperoxidase activity) acutely but did reduce infiltration at 24 hours, even when given after decompression. N-acetylcysteine reduced neutrophil respiratory burst activity. CONCLUSION:N-acetylcysteine administration before or after simulated compartment syndrome preserved striated muscle contractility, apparently by attenuating neutrophil activation and the resultant oxidant injury. CLINICAL RELEVANCE:Our data suggest a potential role for N-acetylcysteine in the attenuation of muscle injury after release of compartment syndrome and possibly in the prophylaxis of compartment syndrome.

journal_name

Clin Orthop Relat Res

journal_title

Clinical orthopaedics and related research

authors

Kearns SR,O'Briain DE,Sheehan KM,Kelly C,Bouchier-Hayes D

doi

10.1007/s11999-010-1287-7

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

2251-9

issue

eissn

0009-921X

issn

1528-1132

journal_volume

468

pub_type

杂志文章

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N-acetylcysteine protects striated muscle in a model of compartment syndrome.