Preoperative intranenous N-Acetylcysteine for the prevention of renal failure in patients with renal impairment undergoing cardiac surgery

Inclusion Criteria1

• Patients with chronic stable renal impairment as evidenced by a creatinine >133µmol//L or creatinine clearance < 50ml/min as estimated by the Cockcroft- Gault formula20. ( Creatinine clearance or CrCl will be calculated by applying the Cockcroft- Gault formula to the baseline serum creatinine level: (140 – age) x weight/ serum creatinine x 0.815; with a female adjustment: CrCl female = CrCl x 0.85)2. Patients undergoing cardiac surgery requiring cardiopulmonary bypass including but not exclusive to coronary artery bypass grafting (CABG), valve surgery, combination CABG and valve replacement procedures, adult patients undergoing surgery for congenital heart disease, repairs of ventricular aneurysm, septal defect repairs and removal of myxomas, stable patients with intraaortic balloon pump (IABP) inserted electively preoperatively, redo cases requiring cardiopulmonary bypass (CPB). 3. Patients who have given consent.