The downside?
Abstract
Delirium is a serious but
potentially avoidable complication in critically ill patients. Various
pathophysiological processes have been associated with delirium
development; however, neuroinflammation hypothesis and pleiotropic
effects are the reasons why HMG-CoA
reductase inhibitors have been evaluated for delirium prevention.
Statin therapy is associated with favorable outcomes in critically ill
patients, but significant variability of results exists in patients who
received these agents postoperatively. Study design methodological
weaknesses, inconsistent delirium assessment, and lack of information on
sedation regimens may have confounded these outcomes. Furthermore, no
evidence exists on the type of statin, lipophilic or non-lipophilic,
that is associated with the most benefit or when therapy with a statin
should be initiated. Thus, the efficacy of HMGM-CoA
reductase inhibitors on delirium prevention has not been fully
established and non-pharmacological methods should remain mainstay of
therapy.
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