Intensive Care Medicine

, Volume 35, Issue 6, pp 1039–1046

Statin administration did not influence the progression of lung injury or associated organ failures in a cohort of patients with acute lung injury

  • Daryl J. Kor
  • Remzi Iscimen
  • Murat Yilmaz
  • Michael J. Brown
  • Daniel R. Brown
  • Ognjen Gajic
Original

DOI: 10.1007/s00134-009-1421-8

Cite this article as:
Kor, D.J., Iscimen, R., Yilmaz, M. et al. Intensive Care Med (2009) 35: 1039. doi:10.1007/s00134-009-1421-8

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.

Keywords

Acute lung injury Acute respiratory distress syndrome Multi-organ failure HMG-CoA reductase inhibitors Statins 

Supplementary material

134_2009_1421_MOESM1_ESM.doc (222 kb)
Table E1. Baseline characteristics for the statin cohort subgroups (DOC 222kb)
134_2009_1421_MOESM2_ESM.doc (81 kb)
Table E2. Patient outcome in the subgroup of statin users whose therapy was continued during the hospitalization (DOC 81kb)
134_2009_1421_MOESM3_ESM.doc (57 kb)
Table E3. Multivariate analysis of intensive care unit length of stay in the subgroup of statin users whose therapy was continued in the hospital (DOC 57kb)

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Daryl J. Kor
    • 1
  • Remzi Iscimen
    • 2
  • Murat Yilmaz
    • 3
  • Michael J. Brown
    • 4
  • Daniel R. Brown
    • 1
  • Ognjen Gajic
    • 5
  1. 1.Division of Critical Care Medicine, Department of AnesthesiologyMultidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C.), Mayo Clinic College of MedicineRochesterUSA
  2. 2.Department of Anesthesiology and ReanimationUludag University School of MedicineBursaTurkey
  3. 3.Department of Anesthesiology and Reanimation, Faculty of MedicineAkdeniz UniversityAntalyaTurkey
  4. 4.Department of AnesthesiologyMayo Clinic College of MedicineRochesterUSA
  5. 5.Division of Pulmonary and Critical Care Medicine, Department of MedicineMultidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C.), Mayo Clinic College of MedicineRochesterUSA

Personalised recommendations