Department of Intensive Care, Erasme University Hospital, Route de Lennik 808, B-1070, Brussels, Belgium.
Ann Intensive Care. 2012 Jun 18;2(1):19. doi: 10.1186/2110-5820-2-19.
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.
他汀类药物在危重症患者中的使用或误用最近引起了重症监护临床医生的关注。事实上,他汀类药物可能是危重病前最常见的慢性治疗药物,一些最近的实验和临床数据表明它们在脓毒症、急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)或蛛网膜下腔出血(aSAH)后具有有益作用。由于当前研究的异质性和缺乏精心设计的前瞻性研究,目前还不能从已发表的证据中得出关于在重症监护病房系统和大规模使用他汀类药物的明确结论。此外,他汀类药物在危重症患者中的副作用程度仍不清楚。对于重症监护临床医生来说,根据当前的文献,根据个体患者的情况来确定他们是否能从这种治疗中获益是一个问题。本综述的目的是描述他汀类药物的作用机制,并综合临床数据,阐明他汀类药物在重症监护特定环境中的相关作用,试图指导临床医生进行日常实践。