Statin therapy could reduce one of the most debilitating pains felt by the critically ill: delirium. A common occurrence in the intensive care unit (ICU), delirium paralyzes patients, manifesting itself as either physical agitation — a restless movement in the limbs — or mental agitation — the inability to distinguish reality from confusion. Delirium disturbs consciousness and currently, no effective or approved medication to treat delirium exists. Doctors still question whether certain medications aggravate or soothe delirium.
But in a recent study from the UK’s Watford General Hospital, researchers show that administering statins to critically ill patients can prevent delirium for patients who have received statins before. Published in the American Journal of Respiratory and Critical Care Medicine, the study examined 470 patients in Watford’s ICU.
One hundred and fifty-one of the 470 patients received statins, and the following day researchers noted a significantly lower level of delirium, as well as a reduced amount of serum c-protein (CRP). Reduced CRP levels signify decreased inflammation. The researchers monitored their patient’s delirium using a novel screening tool called the Confusion Assessment Method-ICU (CAM-ICU).
In a news release, lead author Valerie Page said that “although the pathogenesis of delirium is not fully understood, these data are consistent with a neuro-inflammatory cause and suggest that the anti-inflammatory effects of statins may contribute to the effects of statin treatment on delirium.” Page said the findings advocate the continuation of statin treatment to prevent delirium, but only for patients who received statins before they were admitted to the ICU. Page said more work must be done to understand how exactly statins reduce delirium.
The study also has its limitations. Cognitive assessment tools that measure delirium in patients can only say so much about what the patient is really feeling. The study was also conducted at a single site, meaning results could vary elsewhere. Nevertheless, research will continue to flesh out whether statins can be a viable treatment to prevent delirium.
“The relationship between statin therapy and delirium, and the mechanisms underlying this relationship are the subject of an ongoing randomized, placebo-controlled study in critically ill ventilated patients,” Page said.
Source: Page V, Davis D, Zhao X et al. Statin Use and Risk of Delirium in the Critically Ill. Am J Respir Crit Care Med. 2014.