Statin administration did not influence the progression of lung injury or associated organ failures in a cohort of patients with acute lung injury |
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Authors: | Daryl J Kor Remzi Iscimen Murat Yilmaz Michael J Brown Daniel R Brown Ognjen Gajic |
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Institution: | 1. Division of Critical Care Medicine, Department of Anesthesiology, Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C.), Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA 2. Department of Anesthesiology and Reanimation, Uludag University School of Medicine, Bursa, Turkey 3. Department of Anesthesiology and Reanimation, Faculty of Medicine, Akdeniz University, Antalya, Turkey 4. Department of Anesthesiology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA 5. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C.), Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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Abstract: | Purpose Preclinical studies suggest that HMG-CoA reductase inhibitors (statins) may attenuate organ dysfunction. We evaluated whether
statins are associated with attenuation of lung injury and prevention of associated organ failure in patients with ALI/ARDS.
Methods From a database of patients with ALI/ARDS, we determined the presence and timing of statin administration. Main outcome measures
were the development and progression of pulmonary and nonpulmonary organ failures as assessed by changes in PaO2/FiO2 ratio and Sequential Organ Failure Assessment score (SOFA) between days 1 and 7 after the onset of ALI/ARDS. Secondary outcomes
included ventilator free days, ICU and hospital mortality, and lengths of ICU and hospital stay.
Results From 178 patients with ALI/ARDS, 45 (25%) received statin therapy. From day 1 to day 7, the statin group showed less improvement
in their PaO2/FiO2 ratio (27 vs. 55, P = 0.042). Ventilator free days (median 21 vs. 16 days, P = 0.158), development or progression of organ failures (median ΔSOFA 1 vs. 2, P = 0.275), ICU mortality (20% vs. 23%, P = 0.643), and hospital mortality (27 vs. 37%, P = 0.207) were not significantly different in the statin and non-statin groups. After adjustment for baseline characteristics
and propensity for statin administration, there were no differences in ICU or hospital lengths of stay.
Conclusion In this retrospective cohort study, statin use was not associated with improved outcome in patients with ALI/ARDS. We were
unable to find evidence for protection against pulmonary or nonpulmonary organ dysfunction.
Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users. |
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Keywords: | Acute lung injury Acute respiratory distress syndrome Multi-organ failure HMG-CoA reductase inhibitors Statins |
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