physiological saline + N-acetylcysteine + sodium bicarbonate

This is a combination therapy consisting of physiological saline (isotonic sodium chloride solution), N-acetylcysteine, and sodium bicarbonate. The regimen is primarily used as a prophylactic intervention to prevent contrast-induced acute kidney injury (CI-AKI) in patients undergoing procedures involving iodinated contrast media, such as coronary angiography or percutaneous coronary interventions. - **Physiological saline** provides volume expansion and maintains renal perfusion. - **N-acetylcysteine** acts as an antioxidant, scavenging free radicals and potentially reducing oxidative stress in renal tubular cells. - **Sodium bicarbonate** alkalinizes urine, which may reduce the formation of reactive oxygen species associated with contrast-induced nephropathy. The mechanism involves synergistic effects on reducing oxidative damage to the kidneys by combining hydration (saline), antioxidant action (N-acetylcysteine), and pH modulation (sodium bicarbonate). Clinical studies have shown mixed results regarding efficacy; some meta-analyses suggest a reduction in CI-AKI incidence compared to monotherapy or hydration alone[1][3][6], while other large trials found no significant benefit over standard care[7]. This combination does not have a unique brand name or code name and is typically prepared for use in hospital settings.

Other names

N-acetyl cysteine + sodium bicarbonate + saline-Federal University of São Paulo-contrast-induced acute kidney injuryNAC + sodium bicarbonate + salineIntravenous high-dose N-acetylcysteine and sodium bicarbonate