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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2009

01-06-2009 | Original

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

Authors: Daryl J. Kor, Remzi Iscimen, Murat Yilmaz, Michael J. Brown, Daniel R. Brown, Ognjen Gajic

Published in: Intensive Care Medicine | Issue 6/2009

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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.
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Literature
1.
Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R (1994) The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149:818–824PubMed
2.
The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308CrossRef
3.
Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575PubMedCrossRef
4.
Epstein M, Campese VM (2005) Pleiotropic effects of 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors on renal function. Am J Kidney Dis 45:2–14PubMedCrossRef
5.
Naidu BV, Woolley SM, Farivar AS, Thomas R, Fraga C, Mulligan MS (2003) Simvastatin ameliorates injury in an experimental model of lung ischemia–reperfusion. J Thorac Cardiovasc Surg 126:482–489PubMedCrossRef
6.
Pirat A, Zeyneloglu P, Aldemir D, Yucel M, Ozen O, Candan S, Arslan G (2006) Pretreatment with simvastatin reduces lung injury related to intestinal ischemia–reperfusion in rats. Anesth Analg 102:225–232PubMedCrossRef
7.
Jain R, DalNogare A (2006) Pharmacological therapy for acute respiratory distress syndrome. Mayo Clin Proc 81:205–212PubMedCrossRef
8.
Jacobson JR, Barnard JW, Grigoryev DN, Ma S-F, Tuder RM, Garcia JGN (2005) Simvastatin attenuates vascular leak and inflammation in murine inflammatory lung injury. Am J Physiol Lung Cell Mol Physiol 288:L1026–L1032PubMedCrossRef
9.
Yao HW, Mao LG, Zhu JP (2006) Protective effects of pravastatin in murine lipopolysaccharide-induced acute lung injury. Clin Exp Pharmacol Physiol 33:793–797PubMedCrossRef
10.
Le Manach Y, Coriat P, Collard CD, Riedel B (2008) Statin therapy within the perioperative period. Anesthesiology 108:1141–1146PubMedCrossRef
11.
Poldermans D, Bax JJ, Kertai MD, Krenning B, Westerhout CM, Schinkel AFL, Thomson IR, Lansberg PJ, Fleisher LA, Klein J, van Urk H, Roelandt JRTC, Boersma E (2003) Statins are associated with a reduced incidence of perioperative mortality in patients undergoing major noncardiac vascular surgery. Circulation 107:1848–1851PubMedCrossRef
12.
Lindenauer PK, Pekow P, Wang K, Gutierrez B, Benjamin EM (2004) Lipid-lowering therapy and in-hospital mortality following major noncardiac surgery. JAMA 291:2092–2099PubMedCrossRef
13.
Durazzo AES, Machado FS, Ikeoka DT, De Bernoche C, Monachini MC, Puech-Leao P, Caramelli B (2004) Reduction in cardiovascular events after vascular surgery with atorvastatin: a randomized trial. J Vasc Surg 39:967–975PubMedCrossRef
14.
O’Neil-Callahan K, Katsimaglis G, Tepper MR, Ryan J, Mosby C, Ioannidis JP, Danias PG (2005) Statins decrease perioperative cardiac complications in patients undergoing noncardiac vascular surgery: The Statins for Risk Reduction in Surgery (StaRRS) study. J Am Coll Cardiol 45:336–342PubMedCrossRef
15.
Sukhija R, Bursac Z, Kakar P, Fink L, Fort C, Satwani S, Aronow WS, Bansal D, Mehta JL (2008) Effect of statins on the development of renal dysfunction. Am J Cardiol 101:975–979PubMed
16.
Schouten O, Kok NFM, Boersma E, Bax JJ, Feringa HHH, Vidakovic R, Statius van Eps RG, van Sambeek MRHM, Poldermans D (2006) Effects of statins on renal function after aortic cross clamping during major vascular surgery. Am J Cardiol 97:1383–1385PubMedCrossRef
17.
Pruefer D, Makowski J, Schnell M, Buerke U, Dahm M, Oelert H, Sibelius U, Grandel U, Grimminger F, Seeger W, Meyer J, Darius H, Buerke M (2002) Simvastatin inhibits inflammatory properties of Staphylococcus aureus α-toxin. Circulation 106:2104–2110PubMedCrossRef
18.
Yasuda H, Yuen PS, Hu X, Zhou H, Star RA (2006) Simvastatin improves sepsis-induced mortality and acute kidney injury via renal vascular effects. Kidney Int 69:1535–1542PubMedCrossRef
19.
20.
Almog Y, Shefer A, Novack V, Maimon N, Barski L, Eizinger M, Friger M, Zeller L, Danon A (2004) Prior statin therapy is associated with a decreased rate of severe sepsis. Circulation 110:880–885PubMedCrossRef
21.
Hackam DG, Mamdani M, Li P, Redelmeier DA (2006) Statins and sepsis in patients with cardiovascular disease: a population-based cohort analysis. Lancet 367:413–418PubMedCrossRef
22.
Kruger P, Fitzsimmons K, Cook D, Jones M, Nimmo G (2006) Statin therapy is associated with fewer deaths in patients with bacteraemia. Intensive Care Med 32:75–79PubMedCrossRef
23.
Merx MW, Liehn EA, Janssens U, Lütticken R, Schrader J, Hanrath P, Weber C (2004) HMG-CoA reductase inhibitor simvastatin profoundly improves survival in a murine model of sepsis. Circulation 109:2560–2565PubMedCrossRef
24.
Gao F, Linhartova L, McD Johnston A, Thickett DR (2008) Statins and sepsis. Br J Anaesth 100:288–298PubMedCrossRef
25.
Tseng M-Y, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ (2005) Effects of acute treatment with pravastatin on cerebral vasospasm, autoregulation, and delayed ischemic deficits after aneurysmal subarachnoid hemorrhage: a phase II randomized placebo-controlled trial. Stroke 36:1627–1632PubMedCrossRef
26.
27.
Stapleton RD, Wang BM, Hudson LD, Rubenfeld GD, Caldwell ES, Steinberg KP (2005) Causes and timing of death in patients with ARDS. Chest 128:525–532PubMedCrossRef
28.
Montgomery AB, Stager MA, Carrico CJ, Hudson LD (1985) Causes of mortality in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 132:485–489PubMed
29.
Yilmaz M, Iscimen R, Keegan MT, Vlahakis NE, Afessa B, Hubmayr RD, Gajic O (2007) Six-month survival of patients with acute lung injury: prospective cohort study. Crit Care Med 35:2303–2307PubMedCrossRef
30.
Ferreira FL, Bota DP, Bross A, Melot C, Vincent J-L (2001) Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA 286:1754–1758PubMedCrossRef
31.
Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, Sirio CA, Murphy DJ, Lotring T, Damiano A (1991) The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100:1619–1636PubMedCrossRef
32.
Gueler F, Rong S, Park JK, Fiebeler A, Menne J, Elger M, Mueller DN, Hampich F, Dechend R, Kunter U, Luft FC, Haller H (2002) Postischemic acute renal failure is reduced by short-term statin treatment in a rat model. J Am Soc Nephrol 13:2288–2298PubMedCrossRef
33.
Yokota N, O’Donnell M, Daniels F, Burne-Taney M, Keane W, Kasiske B, Rabb H (2003) Protective effect of HMG-CoA reductase inhibitor on experimental renal ischemia–reperfusion injury. Am J Nephrol 23:13–17PubMedCrossRef
34.
Laufs U, Liao JK (1998) Post-transcriptional regulation of endothelial nitric oxide synthase mRNA stability by Rho GTPase. J Biol Chem 273:24266–24271PubMedCrossRef
35.
Jacobson JR, Dudek SM, Singleton PA, Kolosova IA, Verin AD, Garcia JGN (2006) Endothelial cell barrier enhancement by ATP is mediated by the small GTPase Rac and cortactin. Am J Physiol Lung Cell Mol Physiol 291:L289–L295PubMedCrossRef
36.
Fernandez R, De Pedro VJ, Artigas A (2006) Statin therapy prior to ICU admission: protection against infection or a severity marker? Intensive Care Med 32:160–164PubMedCrossRef
Metadata
Title
Statin administration did not influence the progression of lung injury or associated organ failures in a cohort of patients with acute lung injury
Authors
Daryl J. Kor
Remzi Iscimen
Murat Yilmaz
Michael J. Brown
Daniel R. Brown
Ognjen Gajic
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 6/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1421-8

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