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Lancet. 1990 Jun 30;335(8705):1572-3.

Improved outcome of paracetamol-induced fulminant hepatic failure by late administration of acetylcysteine.

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Liver Unit, King's College Hospital and School of Medicine and Dentistry, London, UK.


The influence of acetylcysteine, administered at presentation to hospital, on the subsequent clinical course of 100 patients who developed paracetamol-induced fulminant hepatic failure was analysed retrospectively. Mortality was 37% in patients who received acetylcysteine 10-36 h after the overdose, compared with 58% in patients not given the antidote. In patients given acetylcysteine, progression to grade III/IV coma was significantly less common than in those who did not receive the antidote (51% vs 75%), although the median peak prothrombin time was similar for both groups. Whether the beneficial effect is related to replenishment of glutathione stores or a consequence of another hepatic protective mechanism of acetylcysteine requires further study.

[Indexed for MEDLINE]

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