Effect of Statin Therapy on Mortality in Patients with Ventilator-Associated Pneumonia

Abstract

Background:Ventilator-associated pneumonia (VAP) affects up to 30 per cent of Intensive care unit (ICU) patients and has been associated with increased morbidity and mortality. The aim of this work was to determine whether adjunctive statin therapy decreased day- 28 mortality among ICU patients with VAP and number of ventilator-free days (after successful weaning) between day 1 and both day 28.

Methods:This prospective randomized control-controlled triple blind study was conducted on 136 patients who had received mechanical ventilation in the ICU for at least 2 days.Cases were divided into two equal groups: Simvastatin group (received 60 mg given via a nasogastric tube or orally) and control group (didn’t receive simvastatin). All patients were subjected to simplified acute physiology score II, radiologic score  and relevant diagnostic and therapeutic interventions in the ICU. Sequential Organ Failure Assessment (SOFA) score,Clinical Pulmonary Infection (CPIS)Score were calculated, serum levels of creatine kinase, ALT, and AST were measured.

Results: SOFA score and CPIS were insignificantly different at all-time measurements between both groups.Acute respiratory distress syndrome (ARDS), myocardial infarction, ICU mortality, 28th day mortality, CK >5×ALT >3× and AST>3× upper limit of normal were insignificantly different between both groups

Conclusions:In adults with suspected VAP, adjunctive simvastatin therapy compared with control group did not improve day-28 survival. These findings do not support the use of statins with the goal of improving VAP outcomes