Department of Anaesthesia and Department of Critical Care Medicine, St Michael's Hospital, University of Toronto, Ontario, Canada.
Excessive inflammatory responses and impaired oxygen utilization because of microcirculatory failure are implicated in septic shock. Recent studies have pointed out some beneficial effects in the treatment of septic shock of several vasodilators that exert anti-inflammatory properties. In particular, the antioxidant N-acetylcysteine has been demonstrated to enhance cardiac performance, and to improve hepatosplanchnic perfusion and liver function in patients with established septic shock. These clinical observations may lead us to examine further the role of antioxidant agents in developing novel therapies for septic shock.