Statins Treatment For ARDS/ALI :a Systematic Analysis And Meta Analysis

ObjectiveTo explore and review the effect of statins applied to acute respiratory distress syndrome(ARDS)/ acute lung injury(ALI)for improvement the clinical outcome.Methodswe searched relevant articles in Pub Med,Cochrane library,Embase database and clinical trials.gov,and made a meta analysis and systematic review.ResultsSix clinical studies were satisfied with the criterion of meta analysis,including three randomized controlled trials(RCT)and three cohort studies,in which the total number of patients was 1345 and 1036,respectively.Meta analysis showed that the results were in RCT studies: RR was 0.98,95% CI ranged 0.83 to 1.17(P = 0.85),and those were in cohort studies: RR was1.02,95% CI ranged 0.80 to 1.31(P = 0.87).The mortality rate of the group with statins treatment was similar to another group of non-statins treatment.About the hospitalization days,the mean difference in RCT was 3.20,95% CI ranged-16.21 to 22.61(P = 0.75),and for non-mechanical ventilation days,the mean difference was 0.40,95% CI ranged-0.71 to1.52(P = 0.48),which indicated the difference between two groups was not statistical significant.For three cohort studies,we used descriptive analysis to describe the hospitalization days and non-mechanical ventilation days,and the results also showed no statistical difference between two groups.Through the literature review,we found that animal experiments showed that statins could reduce the level of inflammatory mediators in ARDS/ALI and improve vascular permeability,which should prevent the deterioration of inflammatory response.However,the clinical studies almost found that statins couldn’t improve the outcome of ARDS/ALI.ConclusionStatins has no significant effect to improve clinical outcome of ARDS/ALI.,although it,maybe can reduce non-pulmonary organ dysfunction.There still need further exploration in the inconsistency between clinical trials and experiments.