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Point and Counterpoint |

COUNTERPOINT: Should Patients Receiving Statins Prior to ICU Admission Be Continued on Statin Therapy? NoContinued Statins in ICU? No

Joel D. Mermis, MD; Steven Q. Simpson, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, University of Kansas School of Medicine.

CORRESPONDENCE TO: Steven Q. Simpson, MD, FCCP, Division of Pulmonary and Critical Care Medicine, University of Kansas School of Medicine, 3901 Rainbow Blvd, Mail Stop 3007, Kansas City, KS 66160; e-mail: ssimpson3@kumc.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(6):1433-1435. doi:10.1378/chest.14-2225
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For every patient admitted to an ICU, providers must make crucial decisions regarding which medications to use to enhance the patient’s likelihood of survival and long-term recovery. Sometimes the decision is only regarding which medications to initiate in the ICU. However, we often must decide which outpatient medications are crucial or desirable to continue in the ICU and which are either not helpful or detrimental to the patient’s current condition. Among the most common drugs that force this decision are the 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, commonly known as statins. Statins are the best selling and most widely used agents in the history of the pharmaceutical industry, and many patients admitted to the ICU with a critical illness have been taking these drugs as outpatients.1 We believe that for most critical illnesses, there is insufficient evidence to warrant continuation of treatment with statins in the ICU setting. To address this issue as a risk analysis proposition, we pose a series of important questions.

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