Efficacy of statin therapy in patients with acute respiratory distress syndrome/acute lung injury: a systematic review and meta-analysis

摘要

OBJECTIVE: Approximately 7.5% of patients admitted to Intensive Care Unit (ICU) of hospitals are likely diagnosed with acute lung injury (ALI) or acute respiratory distress syndrome (ALI/ARDS), and more than one-third of the affected patients die with this disease. Despite the improvement in patient care with the availability of mechanical ventilators, mortality among these patients is unabated. Even though many drugs proved effective in preclinical studies, none is efficacious clinically, and no pharmacological treatment is insight. Statins were reported to exert anti-inflammatory effects and it was suggested that these drugs may be useful in ALI/ARDS patients. However, the initial positive results with statins were not confirmed in later studies, raising doubts about their usefulness. In the present meta-analysis, we examined the efficacy of statins in ALI/ARDS patients. MATERIALS AND METHODS: Various databases were searched to identify both randomized clinical trials and cohort studies, where statin users were compared to non-statin users. To increase the strength of the analysis, cohort studies and random clinical trials were combined in the present analysis. RevMan software from the Cochrane Collaboration was used to a conduct meta-analysis. RESULTS: Baseline characteristics indicated that APACHE-III score to be lower in statin users, suggesting some beneficial effects. However, mortality and severe sepsis were unchanged following statin treatment. But results also showed reduced SOFA score and increased number of ventilator-free days among statin users, indicating that statins are likely to have some beneficial effects. CONCLUSIONS: Statin treatment of ALI/ARDS patients seems to improve health in terms of organ failure and also by lowering the need for ventilation. However, the sample size is too small to accurately assess the effects on mortality and sepsis and further investigations are needed.