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CURRENT ISSUEMINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596

 

Minerva Anestesiologica 2015 August;81(8):921-30

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Statin therapy in critically-ill patients with severe sepsis: a review and meta-analysis of randomized clinical trials

Thomas G. 1, 2, Hraiech S. 1, 2, Loundou A. 3, Truwit J. 4, Kruger P. 5, Mcauley D. F. 6, 7, Papazian L. 1, 2, Roch A. 1, 2

1 Assistance Publique–Hôpitaux de Marseille, Hôpital Nord, Réanimation des Détresses Respiratoires et des Infections Sévères;
2 UMR-CNRS 7278, Aix-Marseile Université, Marseille, France;
3 APHM, Faculté de Médecine Timone, Laboratoire de Santé publique, Marseille, France;
4 Pulmonary and Critical Care Medicine, Froedtert and Medical College of Wisconsin, Milwaukee, WI, USA;
5 Intensive Care Unit, Princess Alexandra Hospital, Wooloongabba, Brisbane, Australia;
6 Centre for Infection and Immunity, Queen’s University of Belfast, Belfast, UK;
7 Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK

While statins are indicated to reduce blood cholesterol levels, they also have anti-inflammatory and immunomodulatory effects. Several observational cohort studies suggested that statins may improve survival and reduce complications in patients with sepsis. Recent randomized controlled studies in critically ill patients have been conducted and published. In this paper we present a meta-analysis of these randomized trials. Methods: An electronic article search through PubMed was performed. Only randomized controlled trials including critically ill adult patients with severe sepsis were retained. A meta-analysis was performed as detailed in text below. Overall analysis including 1818 patients total from 4 studies showed that there was no difference in 60-day mortality between statins (223/903) and placebo (233/899) [risk ratio, 0.930; 95% CI, 0.722 to 1.198]. Similarly, no difference in 28-day mortality was observed between groups (statins 191/907, placebo 199/911; risk ratio 0.953; 95% CI, 0.715 to 1.271). The results of this meta-analysis confirm that the use of statin therapy should not be recommended in the management of severe sepsis in critically ill patients. Statins should be continued with caution and only if necessary, as one study reported that the statin group had a higher rate of hepatic and renal failure.

language: English


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