statins in the critically ill他汀类药物在病危.pdfVIP

De Loecker and Preiser Annals of Intensive Care 2012, 2:19 /content/2/1/19 REVIEW Open Access Statins in the critically ill * Isabelle De Loecker and Jean-Charles Preiser Abstract The use or misuse of statins in critically ill patients recently attracted the attention of intensive care clinicians. Indeed, statins are probably the most common chronic treatment before critical illness and some recent experimental and clinical data demonstrated their beneficial effects during sepsis, acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), or after aneurismal subarachnoidal hemorrhage (aSAH). Due to the heterogeneity of current studies and the lack of well-designed prospective studies, definitive conclusions for systematic and large-scale utilization in intensive care units cannot be drawn from the published evidence. Furthermore, the extent of statins side effects in critically ill patients is still unknown. For the intensive care clinician, it is a matter of individually identifying the patient who can benefit from this therapy according to the current literature. The purpose of this review is to describe the mechanisms of actions of statins and to synthesize the clinical data that underline the relevant effects of statins in the particular setting of critical care, in an attempt to guide the clinician through his daily practice. Keywords: Mevalonate, HMG-CoA reductase, Sepsis, Acute lung injury, Acute respiratory distress syndrome, Subarachnoid hemorrhage Review with acute arteriosclerotic cardiovascular disease [6]. Background Heeschen et al. investigated the effects of statins on the