Statin research in critical illness hampered by poor trial design 英文参考文献.docVIP

Available online /content/13/6/1015 Commentary Statin research in critical illness: hampered by poor trial design? Marius Terblanche1 and Neill KJ Adhikari2 1Department of Critical Care Medicine, Guy’s and St Thomas’ NHS Foundation Trust, London, UK 2Department of Critical Care Medicine, Sunnybrook Health Sciences Centre University of Toronto, Toronto, Ontario, Canada Correspondence to: Marius Terblanche, Marius.terblanche@gstt.nhs.uk See related research by Morgan et al., /content/13/5/R165 Published: 11 December 2009 Critical Care 2009, 13:1015 (doi:10.1186/cc8173) This article is online at /content/13/6/1015 ? 2009 BioMed Central Ltd Abstract measured by IL-6, IL-8, C-reactive protein and tumour necrosis factor-alpha. Statin therapy may prevent an excessive inflammatory response after cardiopulmonary bypass for cardiac surgery. In a recent issue of Critical Care, Morgan and colleagues present data from a well- conducted systematic review and meta-analysis of randomised controlled trials using inflammatory markers as primary outcome measure. They find that pre-operative statin therapy, compared with placebo, may reduce various post-operative markers of The studies included were generally of suboptimal methodo- logical quality. For example, six of the eight apparently randomised studies provide no information on sequence generation and allocation concealment. Three were unblinded and only two had a low risk of bias (defined by applying the Cochrane risk of bias tool). The median sample size was 43.5 (range 20 to 200) and the confidence intervals around the mean differences in inflammatory markers for individual studies and for the summary estimates were fairly wide. Other studies of inflammatory biomarkers are likely to vary widely between patients and within patients over time, suggesting that analysis of within-patient changes