الفهرس 
Ventilator Associated PneumoniaOnly 14 pages are availabe for public view
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Abstract
Background: Although pneumonia is one of the oldest well described diseases, and despite the revolutionary impact of antibiotics on pneumonia-related mortality and morbidity, lower respiratory tract infection LRTI (including pneumonia) remain among the top 3 killers worldwide, and one of the top 10 killers in Egypt.
Aim of the workd: This study aims to determine whether adjunctive statin therapy decreased day- 28 mortality among ICU patients with VAP& number of ventilator-free days (after successful weaning) between day 1 and both day 28.
Patient and Method: Patients were randomly allocated to simvastatin (60 mg) or control given via a nasogastric tube or orally from study inclusion to ICU discharge, death, or day 28, whichever occurred first. Simvastatin or control were started on the same day as antibiotic therapy for suspected VAP. The simvastatin dosage was halved in patients with renal failure (creatinine clearance <30 mL/min). 136 patients were randomly allocated into two groups (68 patients in each).
Results: Patients’ characteristics (Age, sex and BMI) were insignificantly different between both groups. On admission heart rate, mean arterial blood pressure, temperature, SAPS II at admission was insignificantly different between both groups and PaO2/FiO2 were insignificantly different between both groups. While SOFA score and CPIS was insignificantly different at all-time measurements between both groups. Duration of mechanical ventilation, ICU stay, mechanical ventilation free days and ICU stay free days were insignificantly different between both groups. ARDS, myocardial infarction, ICU mortality and 28th day mortality were insignificantly different between both groups. CK >5×, AST >3× and ALT >3× upper limit of normal was was insignificantly different at all-time measurements between both groups.
Conclusion: In adults with suspected VAP, adjunctive simvastatin therapy compared with control group did not improve day-28 survival. These findings do not support the use of statins with the goal of improving VAP outcomes.