Background : Patients with deranged ventricular systolic function undergoing valve surgery are at high risk of low cardiac output syndrome (LCOS). N- acetylcysteine (NAC), a glutathione precursor and antioxidant, has been investigated in cardiac surgery with incongruous results. Evidence in the subset of poor ventricles after valve surgery is grossly deficient. Methods :We performed a retrospective observational study of consecutive adults with ventricular dysfunction or global hypokinesia who underwent on- pump valve surgery at a newly established tertiary cardiac unit. Patients were managed with a post operative NAC protocol. Results :Total 9 patients were studied.Baseline demographics and surgical complexity were comparable after adjustment.NAC use within 48 hours of surgery was associated with a lower period of icu stay (5 days vs 12 days), reduced VIS (mean difference 14). Improvement of renal function was earlier. Hospital stay was shorter in the NAC cohort (19 days vs 24 days). 1 patient succumbed to death due to sustained non responsive ventricular fibrillation.NAC was not given in this patient.Post operative atrial fibrillation was absent in patient with preoperative tachybradyarrythmia who received NAC before 48 hrs. No adverse reactions to NAC were documented. Conclusion : In this original article study of high-risk cohort of patients with poor ventricular function undergoing valve surgery, a pragmatic N-Acetyl Cysteine protocol was associated with reduced Low Cardiac Output Syndrome and improved hemodynamic stability without added safety concerns. These findings highlight the potential of NAC as an adjunct in managing vulnerable patients with impaired Ventricular function..
Keywords: : N\A.
How to cite this article: Pathak S, Yadav R, Srivastava AK.; N-acetyl cysteine after valve Surgery in poor ventricles: a pragmatic protocol.Int J Drug Deliv Technol. 2026;16(1s): 612-616; DOI: 10.25258/ijddt.16. 617-621