In 2009, the first prospective, randomized
controlled study of i.v. acetylcysteine
in NAI-ALF was published.
In this study by Lee et al.,9 173 adult
patients with NAI-ALF were randomly
assigned to receive either acetylcysteine
or placebo for 72 hours.
Acetylcysteine was administered as a
loading dose of 150 mg/kg per hour
over 1 hour, followed by a continuous
infusion of 12.5 mg/kg per hour for 4
hours and then 6.25 mg/kg per hour
for an additional 67 hours. Randomized
patients were stratified by coma
grade, with the majority of patients
having low-grade encephalopathy