Brain metabolic and hemodynamic effects of cyclosporin A after human severe traumatic brain injury: a microdialysis study

Abstract

The administration of CsA in the early phase after head injury resulted in significantly higher extracellular fluid glucose and pyruvate, which may be evidence of a beneficial effect. The early administration of CsA was also associated with a significant increase in MAP and CPP and such a potentially beneficial hemodynamic effect might contribute to a neuroprotective effect.

Safety and Tolerability of Cyclosporin A in Severe Traumatic Brain Injury Patients: Results from a Prospective Randomized Trial

“…Cultures were also performed as indicated according to the clinical course during the overall period of hospital stay. These immunological data and infection complications have already been reported (Mazzeo et al, 2008).…”

“…The effect of CsA infusion on blood pressure after head injury has been previously reported (Mazzeo et al, 2008). After the initiation of the CsA infusion, an increasing mean arterial pressure (MAP) was seen in the drug treated group, with MAP levels reaching a mean value of 105 mm Hg at 56 h after injury (Fig.…”

“…5. The figure shows the cyclosporin A (CsA) blood level throughout the monitoring period in the 4 patients in whom it exceeded 1000 ng=mL (A), and the mean blood levels for the entire CsA-treated group (mean AE standard deviation) (B) (Modified from Mazzeo et al, 2008). through selective inhibition of the immune response.…”

“…The safety and tolerability of CsA are reported here. Other aspects of drug administration, such as its effects on cellmediated immunological function, and brain neurochemistry and cerebral and systemic hemodynamics, have been reported previously (Mazzeo et al, 2006(Mazzeo et al, , 2008.…”

“…4B). The recorded CPP values were subsequently significantly higher in the CsA-treated group than in the placebo-treated group throughout the 7-day monitoring period ( p < 0.01) (Mazzeo et al, 2008). Nevertheless, no significant difference was recorded in the two groups in the occurrence of clinically significant hypertension, confirming that even if MAP was maintained at higher levels in CsA-treated patients, these values remained within the normal range, and did not require therapeutic intervention to avoid clinical adverse effects.…”