Commentary
Ethyl pyruvate for the treatment of acetaminophen intoxication: alternative to N-acetylcysteine?
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* Corresponding author: Peter Radermacher peter.radermacher@uni-ulm.de
1 Sektion Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Klinik für Anästhesiologie, Universitätsklinikum, Helmholtzstrasse 8-1, D-89081 Ulm, Germany
2 Laboratoire HIFIH, UPRES EA 3859, IFR 132, Université d'Angers, Département de Réanimation Médicale et de Médecine Hyperbare, Centre Hospitalo-Universitaire, 4 rue Larrey, 49933 Angers Cedex 09, France
Critical Care 2012, 16:112 doi:10.1186/cc11153
See related research by Yang et al., http://ccforum.com/content/16/1/R9
Published: 20 February 2012Abstract
N-acetylcysteine is the classical antidote for acetaminophen overdose-induced hepatotoxicity, but its efficacy is limited by the need for early and only temporary treatment. Therefore, Yang and colleagues tested the hypothesis of whether ethyl pyruvate - another anti-inflammatory and antioxidant compound, which they had previously shown to protect against liver injury of various other etiologies - may allow circumventing these limitations. While ethyl pyruvate improved liver regeneration when administered early and during a limited period only, the opposite response was present both after delayed as well as prolonged treatment. The authors concluded that prolonged anti-inflammatory treatment is detrimental after acetaminophen intoxication-induced liver damage. On the one hand, this research paper confirms the need for biomarkers to monitor organ recovery after acetaminophen. On the other hand, this paper adds to the ongoing discussion on the usefulness of ethyl pyruvate as a resuscitation fluid in the critically ill.