High-dose cimetidine reduces proinflammatory reaction after cardiac surgery with cardiopulmonary bypass.
BACKGROUND
Cimetidine, which is usually used for gastric ulcer, enhances cellular immunity. The effect of cimetidine on perioperative proinflammatory response after cardiac surgery with cardiopulmonary bypass was investigated.


METHODS
Elective coronary artery bypass graft cases in which CPB was performed were placed randomly in a cimetidine (C) group (n = 20) or a no-treatment (N) group (n = 20). The time course of plasma levels of neutrophil elastase, interleukin (IL)-6 and IL-8, leukocyte counts, lymphocyte recovery ratio, C-reactive protein, creatine-kinase-MB, and oxygenation index were analyzed.


RESULTS
The plasma levels of neutrophil elastase and IL-8 were inhibited in the C groups at 2 hours after CPB termination. In a comparison of the two groups, the C group demonstrated higher lymphocyte recovery ratio and lower C-reactive protein on postoperative day 5 and shorter intubation time. No intergroup differences were observed in IL-6, leukocyte counts, creatine-kinase-MB levels, or oxygenation index.


CONCLUSIONS
Cimetidine may reduce surgical stress and augment the immune system after cardiac surgery with cardiopulmonary bypass.
Tayama
E
E
Department of Surgery, Kurume University School of Medicine, Kurume-city, Japan. eiki@med.kurume-u.ac.jp
Hayashida
N
N
Fukunaga
S
S
Tayama
K
K
Takaseya
T
T
Hiratsuka
R
R
Aoyagi
S
S
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D002927:Cimetidine / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000037:antagonists & inhibitors / Q000097:blood; D007958:Leukocyte Count; D019272:Leukocyte Elastase / Q000037:antagonists & inhibitors / Q000097:blood; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology / Q000517:prevention & control*; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology / Q000517:prevention & control*
D015850:Interleukin-6; D016209:Interleukin-8; D002927:Cimetidine; D002097:C-Reactive Protein; D019272:Leukocyte Elastase