Statins and sepsis

Abstract

Severe sepsis and septic shock is common and frequently fatal. Over the last few years, the primary treatments demonstrated to improve outcome from several major clinical trials have finally emerged. However, translating these recent therapeutic advances to routine clinical practice has proven controversial, and new approaches of additional strategies are continued to be developed. Given their pleiotropic effects related to many pathophysiological determinants of sepsis, statin therapy could be the next step in the search for adjuvant therapy. A future challenge may be to test both the efficacy and the safety by large randomized controlled clinical trials ascertaining the effects of statins administered at the onset of sepsis and in patients with severe sepsis or septic shock admitted into intensive care units.

Can statins improve outcome in colorectal surgery?: Part I

“…On the other hand, there are evidences [21][22][23][24] and controversies [25][26][27][28][29] that require a better definition that statins, independent of their primary action, help reduce mortality in the treatment of sepsis 21,25,30 , supposedly for inhibiting the synthesis of products of the cholesterol metabolic pathway just before mevalonate is produced, preventing the production of substances such as isoprenoids and geranylgeranyl pyrophosphate 31 . In addition, they modify the intercellular interaction and the chemotaxis of the immune system; have antioxidant properties, although reducing the levels of ubiquinone (CoQ10), an endogenous oxidant 32 ; act against apoptosis; inhibit the action of certain genes, changing the cellular activity; and participate, in other mechanisms, of the inflammatory response 30 , facts that intensify their capability to control the systemic inflammatory response syndrome and protect cardiac patients from complications of noncardiac surgeries [33][34][35] or in similar situations triggered by the infection [22][23][24]36,37 .…”

Comparing the anti-inflammatory effects of Simvastatin and Rosuvastatin by measuring IL-1β, IL-6 and TNF-α levels using a murinic caecal ligation and puncture induced sepsis model / Compararea efectelor anti-inflamatoare ale Simvastatinei și Rosuvastatinei măsurând nivelele serice ale IL-1β, IL-6 si TNF-α folosind un model de sepsis la șobolan indus prin ligatură și puncție cecală

“…Others stated that established statin treatment should be continued because the cessation of such treatment is associated with worse survival rates (22). But the majority agree that more data is needed before a definitive conclusion may be drawn (23,24). The main questions that still remain to be answered are witch statin is best for the septic patient, when should this be administered and what dose would be safe for this group of patients.…”

Intelligent Management of Sepsis in the Intensive Care Unit

“…Recent studies suggest that chronic treatment with statins would present beneficial effects for infection prevention and treatment. There is suggestion as well of a possible beneficial effect in ICU outcome [92,93,94,95,96,97,98,99,100,101]. Despite this evidence, several studies have only found a neutral effect [102], or even a greater mortality in patients treated with statins [103] in this environment.…”