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Statins in the critically ill 英文参考文献
DeLoeckerandPreiserAnnalsofIntensiveCare2012,2:19
/content/2/1/19
REVIEW
OpenAccess
Statinsinthecriticallyill
IsabelleDeLoeckerandJean-CharlesPreiser*
Abstract
Theuseormisuseofstatinsincriticallyillpatientsrecentlyattractedtheattentionofintensivecareclinicians.
Indeed,statinsareprobablythemostcommonchronictreatmentbeforecriticalillnessandsomerecent
experimentalandclinicaldatademonstratedtheirbeneficialeffectsduringsepsis,acutelunginjury(ALI)/acute
respiratorydistresssyndrome(ARDS),orafteraneurismalsubarachnoidalhemorrhage(aSAH).Duetothe
heterogeneityofcurrentstudiesandthelackofwell-designedprospectivestudies,definitiveconclusionsfor
systematicandlarge-scaleutilizationinintensivecareunitscannotbedrawnfromthepublishedevidence.
Furthermore,theextentofstatinssideeffectsincriticallyillpatientsisstillunknown.Fortheintensivecareclinician,
itisamatterofindividuallyidentifyingthepatientwhocanbenefitfromthistherapyaccordingtothecurrent
literature.Thepurposeofthisreviewistodescribethemechanismsofactionsofstatinsandtosynthesizethe
clinicaldatathatunderlinetherelevanteffectsofstatinsintheparticularsettingofcriticalcare,inanattemptto
guidetheclinicianthroughhisdailypractice.
Keywords:Mevalonate,HMG-CoAreductase,Sepsis,Acutelunginjury,Acuterespiratorydistresssyndrome,
Subarachnoidhemorrhage
Review
Background
with acute arteriosclerotic cardiovascular disease [6].
Heeschen et al. investigated the effects of statins on the
The use or misuse of statins in critically ill patients re- cardiaceventratein1,616patientsofthePlateletRecep-
centlyattractedtheattentionofintensive care clinicians tor Inhibition in Ischemic Syndrome Management
for several different reasons. First, statins are probably (PRISM) study who had coronary artery disease and
the most common chronic treatment before critical ill- chestpainduringtheprevious24h.Ifthestatintherapy
ness. These lipid-lowering drugs are widely prescribed was withdrawn after admission for acute coronary syn-
(18 million prescription
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