Abstract

Statins have become the most widely used drugs for lowering cholesterol levels worldwide. At least 20% of patients requiring admission to hospital are on established statin therapy, and this proportion is growing each year. Evidence from observational studies and basic science research suggests that statins might be associated with a reduced mortality in sepsis. Randomized trials are producing equivocal results but have not shown the marked improvement in outcome suggested by the observational studies. Continued use in current statin users appears a more fruitful area for future research than statin use de novo as an adjuvant therapy in sepsis. Statin use in patients with pneumonia, acute lung injury or early sepsis warrants further study. International practice of statin use in critically ill patients is variable, and potential toxicity mandates careful monitoring. Further studies are required to address fundamental issues such as efficacy, potential target patient populations, dose, class equivalence and safety.

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