Inclusion Criteria:  Criteria for inclusion will be  Age between 18 and 70 years Establishment of ACLF grade 1-3 according to EASL- CLIFF criteria Willing to provide informed consent to participate in the study (by study subject or next of kin)  Exclusion Criteria:  Criteria for exclusion will be  History of hypersensitivity to NAC Hepatocellular carcinoma pregnancy Advanced cardiovascular or pulmonary disease Advanced primary neurological disease (such as stroke)