-- Robert Preidt
WEDNESDAY, Oct. 9 (HealthDay News) -- Three different efforts to
improve outcomes among patients in intensive-care units have
produced mixed results.
Using statins and trying different intravenous fluids made
little difference for these sickest of patients, but giving beta
blockers to those in severe septic shock provided some protection
for their hearts, the studies showed.
All three reports were published online Oct. 9 in the
Journal of the American Medical Associationto coincide with
presentations at the European Society of Intensive Care Medicine
annual meeting in Paris.
The first report found that statins do not reduce the risk of
death for adult patients in ICUs with ventilator-associated
pneumonia. Some previous research had suggested that statins were
effective against certain types of infections, according to the
The latest research included 300 patients at 16 ICUs in France
with ventilator-associated pneumonia, which is the most common
infection among ICU patients, affecting between 8 percent and 28
percent of those on mechanical ventilation. Half of the patients
received simvastatin and half were given a placebo.
After 28 days, the death rates were 21.2 percent in the
simvastatin group and 15.2 percent in the placebo group. There were
no differences in ICU or hospital death rates, or in the length of
time that patients remained on mechanical ventilation.
The findings do not support the use of statins in patients with
ventilator-associated pneumonia, Dr. Laurent Papazian, of Hospital
Nord in Marseille, said in a journal news release.
A second study found the risk of death was the same among ICU
patients who received two different types of fluid-replacement
It's common for ICU patients to receive intravenous fluids,
which include a wide number of products categorized as crystalloids
or colloids. Crystalloids are salts, while colloids are salts and
gelatin, starch or protein. Many doctors believe crystalloids are
better than colloids for treating critically ill patients,
according to background information included in the study.
Researchers looked at more than 2,800 critically ill patients at
57 ICUs in France, Belgium, North Africa and Canada. About half of
them received crystalloids and half received colloids.
Both groups had similar death rates after 28 days (25.4 percent
in the colloids group and 27 percent in the crystalloids group) and
after 90 days (30.7 percent in the colloids group and 34.2 percent
in the crystalloids group).
The findings are "exploratory" and further research is needed
before reaching any conclusions about the use of either type of
fluid therapy in ICU patients, Dr. Djillali Annane, of Raymond
Poincare Hospital in France, said in the news release.
A third study found that the beta blocker esmolol helped achieve
the target heart rate in ICU patients with severe septic shock and
a high risk of death. Septic shock can affect heart function and
beta blockers are meant to control heart rate and improve heart
In this study, 77 patients received standard treatment and 77
others received a continuous infusion of esmolol to maintain their
heart rate between 80 and 94 beats per minute throughout their ICU
After 28 days, the death rates were 80.5 percent in the standard
treatment group and 49.4 percent in the esmolol group.
"Further investigation of the effects of esmolol on clinical outcomes is warranted," Dr. Andrea Morelli, of the University of Rome, wrote in the news release.
The American Thoracic Society has more about
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