• Edgars Grins, Per Ederoth, Henrik Bjursten, Alain Dardashti, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J Hansson, Eskil Elmér, Lars Algotsson, Nabin Manandhar Shrestha, and Stefan Jovinge.
• Department of Cardiothoracic Anesthesia and Intensive Care, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden. Electronic address: Edgars.Grins@med.lu.se.
• J. Cardiothorac. Vasc. Anesth. 2022 Jul 1; 36 (7): 1985-1994.

ObjectivesThe augmented inflammatory response to cardiac surgery is a recognized cause of postoperative acute kidney injury. The present study aimed to investigate the effects of preoperative cyclosporine treatment on cytokine production and delineate factors associated with postoperative kidney impairment.DesignA randomized, double-blind, placebo-controlled, single-center study.SettingAt a tertiary care, university hospital.ParticipantsPatients eligible for elective coronary artery bypass grafting surgery; 67 patients were enrolled.InterventionsPatients were randomized to receive 2.5 mg/kg cyclosporine or placebo before surgery. Cytokine levels were measured after the induction of anesthesia and 4 hours after the end of cardiopulmonary bypass.Measurements And Main ResultsTissue-aggressive (interleukin [IL]-1β, macrophage inflammatory protein [MIP]-1β, granulocyte colony-stimulating factor [G-CSF], IL-6, IL-8, IL-17, MCP-1), as well tissue-lenient (IL-4) cytokines, were significantly elevated in response to surgery. Changes in cytokine levels were not affected by cyclosporine pretreatment.ConclusionsElective coronary artery bypass grafting surgery with cardiopulmonary bypass triggers cytokine activation. This activation was not impacted by preoperative cyclosporine treatment.Copyright © 2021 Elsevier Inc. All rights reserved.

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