High-dose cimetidine reduces proinflammatory reaction after cardiac surgery with cardiopulmonary bypass

Background. Cimetidine, which is usually used for gastric ulcer, enhances c ellular immunity. The effect of cimetidine on perioperative proinflammatory response after cardiac surgery with cardiopulmonary bypass was investigate d. Methods. Elective coronary artery bypass graft cases in which CPB was perfo rmed were placed randomly in a cimetidine (C) group (n = 20) or a no-treatm ent (N) group (n = 20). The time course of plasma levels of neutrophil elas tase, interleukin (IL)-6 and IL-8, leukocyte counts, lymphocyte recovery ra tio, C-reactive protein, creatine-kinase-MB, and oxygenation index were ana lyzed. Results. The plasma levels of neutrophil elastase and IL-8 were inhibited i n 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 lowe r C-reactive protein on postoperative day 5 and shorter intubation time. No intergroup differences were observed in IL-6, leukocyte counts, creatine-k inase-MB levels, or oxygenation index. Conclusions. Cimetidine may reduce surgical stress and augment the immune s ystem after cardiac surgery with cardiopulmonary bypass. (C) 2001 by The So ciety of Thoracic Surgeons.