Individualized Multiplex Pathophysiological Treatment of Severe Acute Infections: N-Acetylcysteine

Inclusion criteria 1. Age ≥18 years 2. Documented clinical suspicion of infection 3. Model for end-stage liver disease (MELD) score ≥9 Exclusion criteria 1. Admitted to hospital \>24 hours before randomization 2. Any previous severe anaphylaxis 3. Other known allergy to N-acetylcysteine 4. Ongoing treatment with N-acetylcysteine at randomization 5. Documented clinical suspicion of bile duct obstruction 6. Refractory circulatory shock 7. Informed consent not obtainable 8. Inability to read and understand Danish to a degree that allows valid informed consent and completion of trial assessments 9. Involuntary admission under the psychiatric law 10. Expected initiation of palliative care within 48 hours of randomization 11. Ongoing treatment with nitroglycerin 12. Any other condition deemed by the investigator to compromise patient safety or trial integrity (e.g., severe coagulopathy, uncontrolled bleeding, diabetic ketoacidosis)