Effect of pravastatin on the frequency of ventilator-associated pneumonia and on intensive care unit mortality: Open-label, randomized study
Critical Care Medicine, 10/18/2011
Makris D et al. – This study provides evidence that pravastatin may favorably affect the outcome of critical care patients.Methods
- Consecutive patients were recruited from the intensive care units of the two hospitals.
- Patient inclusion criteria included mechanical ventilation and intensive care unit stay of >48 hrs.
- The two arms consisted of treatment plus oral pravastatin sodium (40 mg) (n=71 patients, pravastatin group) and treatment without pravastatin (n=81 patients, control group).
- Treatment was started after randomization and ended 30 days later.
- Ventilator-associated pneumonia frequency and intensive care unit mortality at 30 days and at the end of intensive care unit stay were measured.
- Adverse events related to statin treatment in the intensive care unit were documented.
- Sixteen patients (22.5%) in the pravastatin group and 28 (34.5%) in the control group (p=.11) presented pneumonia during the 30-day treatment period in the intensive care unit.
- There was an indication for increased probability of being free from ventilator-associated pneumonia during the 30-day treatment period in the pravastatin group compared to the control group (p=.06) and significantly increased probability during the whole intensive care unit period of stay (p=.04) in the pravastatin group compared to the control group in the subgroup of patients with Acute Physiology and Chronic Health Evaluation scores of ≥15.
- Six patients (8.45%) in the pravastatin group and 16 (19.85%) in the control group died during the 30-day treatment period (p=.06), whereas 10 (14.1%) patients in the pravastatin group and 24 (29.1%) patients in the control group died during the whole period of intensive care unit stay (p=.03).
- Pravastatin group patients with Acute Physiology and Chronic Health Evaluation scores of ≥15 had significantly increased probability of survival compared to controls during the 30-day treatment period (p=.04).
- Creatine kinase and hepatic function enzyme levels during the whole study period were not significantly different between the pravastatin group and control group.