Abstract
Sepsis is a common intensive care unit event occurring in approximately 750 000 patients annually, with a case mortality rate approaching 50%. Sepsis is characterized by a chaotic and excessive release of inflammatory cytokines and procoagulants including tumor necrosis factor, interleukin (IL)-1, IL-6, IL-8, platelet-activating factor, and tissue factor. Efforts to inhibit individual cytokines in order to modify poor outcomes have been generally disappointing, suggesting the need to target multiple inflammatory mediators to obtain clinical benefit. Statins lower lipids by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which in turn inhibits the rate-limiting step in cholesterol biosynthesis. In addition to lowering total cholesterol, statins have pleiotropic effects on inflammation and immunity. Instead of impacting a single entity in the sepsis syndrome, statins may have positive effects on multiple inflammatory, immunomodulating, and coagulation targets involved in the development of infection and sepsis. There have been a number of institutional- and population-based studies that have evaluated the impact of statins in patients with infection and sepsis. Most of these studies, but not all, have demonstrated a number of positive outcomes in patients with statins, including reduction in mortality. Based on these data, statins are a promising therapy in the management of patients with sepsis and warrant larger and more rigorous clinical trials.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 38-49 |
| Number of pages | 12 |
| Journal | Journal of Pharmacy Practice |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| State | Published - Mar 19 2010 |
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Keywords
- Critical care
- Inflammation
- Pneumonia
- Sepsis
- Statins
ASJC Scopus subject areas
- Pharmacology (medical)
Cite this
Statins in sepsis. / Dobesh, Paul P; Swahn, Stephanie M.; Peterson, Evan J.; Olsen, Keith Melvin.
In: Journal of Pharmacy Practice, Vol. 23, No. 1, 19.03.2010, p. 38-49.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Statins in sepsis
AU - Dobesh, Paul P
AU - Swahn, Stephanie M.
AU - Peterson, Evan J.
AU - Olsen, Keith Melvin
PY - 2010/3/19
Y1 - 2010/3/19
N2 - Sepsis is a common intensive care unit event occurring in approximately 750 000 patients annually, with a case mortality rate approaching 50%. Sepsis is characterized by a chaotic and excessive release of inflammatory cytokines and procoagulants including tumor necrosis factor, interleukin (IL)-1, IL-6, IL-8, platelet-activating factor, and tissue factor. Efforts to inhibit individual cytokines in order to modify poor outcomes have been generally disappointing, suggesting the need to target multiple inflammatory mediators to obtain clinical benefit. Statins lower lipids by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which in turn inhibits the rate-limiting step in cholesterol biosynthesis. In addition to lowering total cholesterol, statins have pleiotropic effects on inflammation and immunity. Instead of impacting a single entity in the sepsis syndrome, statins may have positive effects on multiple inflammatory, immunomodulating, and coagulation targets involved in the development of infection and sepsis. There have been a number of institutional- and population-based studies that have evaluated the impact of statins in patients with infection and sepsis. Most of these studies, but not all, have demonstrated a number of positive outcomes in patients with statins, including reduction in mortality. Based on these data, statins are a promising therapy in the management of patients with sepsis and warrant larger and more rigorous clinical trials.
AB - Sepsis is a common intensive care unit event occurring in approximately 750 000 patients annually, with a case mortality rate approaching 50%. Sepsis is characterized by a chaotic and excessive release of inflammatory cytokines and procoagulants including tumor necrosis factor, interleukin (IL)-1, IL-6, IL-8, platelet-activating factor, and tissue factor. Efforts to inhibit individual cytokines in order to modify poor outcomes have been generally disappointing, suggesting the need to target multiple inflammatory mediators to obtain clinical benefit. Statins lower lipids by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which in turn inhibits the rate-limiting step in cholesterol biosynthesis. In addition to lowering total cholesterol, statins have pleiotropic effects on inflammation and immunity. Instead of impacting a single entity in the sepsis syndrome, statins may have positive effects on multiple inflammatory, immunomodulating, and coagulation targets involved in the development of infection and sepsis. There have been a number of institutional- and population-based studies that have evaluated the impact of statins in patients with infection and sepsis. Most of these studies, but not all, have demonstrated a number of positive outcomes in patients with statins, including reduction in mortality. Based on these data, statins are a promising therapy in the management of patients with sepsis and warrant larger and more rigorous clinical trials.
KW - Critical care
KW - Inflammation
KW - Pneumonia
KW - Sepsis
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=77949385932&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77949385932&partnerID=8YFLogxK
U2 - 10.1177/0897190009356548
DO - 10.1177/0897190009356548
M3 - Review article
VL - 23
SP - 38
EP - 49
JO - Journal of Pharmacy Practice
JF - Journal of Pharmacy Practice
SN - 0897-1900
IS - 1
ER -