Background: Statins anti-inflammatory and antioxidant properties improve vascular function in septic patients. The aim of this prospective study was to assess vasopressor effect and safety of rosuvastatin therapy in septic patient. Methods: One hundred and eight patients admitted to intensive care unit (ICU) with suspected or confirmed infection plus at least 2 systemic inflammatory response syndrome criteria were included in this prospective double-blinded randomized two groups' parallel study. Group R received standard therapy and rosuvastatin 20 mg/day and Group C received standard therapy with placebo/day for 14 days. The primary endpoint was number of acceptable blood pressure and systemic perfusion days (ABPSPD). Secondary outcome included time to initial ABPSPD, vasopressor dose and duration, arterial lactate, organ dysfunction or failure free days, ICU and hospital stay, 28 ICU and hospital mortality, CPK and transaminases level. Results: The number of ABPSPD was significantly increased 11(3) vs. 8 (3) (p = 0.0001), with a shorter time to initial ABPSPD 18(21) vs. 41(37) h (p = 0.0001) in Group R than Group C. Norepinephrine dose 0.8 (0.5) vs. 1.6 (0.6) and duration 3(2) vs. 6(3) were significantly reduced in Group R with no significant elevation in transaminases or CPK. Conclusions: Rosuvastatin 20 mg/day in septic patients increased number ABPSPD, decreased time to initial ABPSPD, norepinephrine dose and duration, with no significant elevation in transaminases or CPK.

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Background Hyperglycemia is a risk factor for infarct expansion and poor outcome for both diabetic and non-diabetic patients. We aimed to study the prognostic value of stress hyperglycemia on the outcome of acute ischemic stroke patients as regards National Institutes of Health Stroke Scale (NIHSS) as a primary outcome. Results Patients with high random blood sugar (RBS) on admission showed significantly higher values of both median NIHSS score and median duration of hospital stay. There were significant associations between stress hyperglycemia and the risk of 30-day mortality (p < 0.001), the need for mechanical ventilation (p < 0.001) and vasopressors (p < 0.001), and the occurrence of hemorrhagic transformation (p = 0.001). The 24-h RBS levels at a cut off > 145 mg/dl showed a significantly good discrimination power for 30-day mortality (area under the curve = 0.809). Conclusions Stress hyperglycemia had a prognostic value and was associated with less-favorable outcomes of acute stroke patients. Therefore, early glycemic control is recommended for those patients.

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