Background
ARDS
ACUTE RESPIRATORY DISTRESS SYNDROME, CRITICAL ILLNESS, ARDS
Acute respiratory distress syndrome (ARDS) is a heterogeneous condition with high mortality and lacks targeted medical therapies [Interestingly, the effect of statin medications on lipid profiles as it pertains to outcomes in critical illness has not been well studied. Cholesterol has proposed roles in normal lung physiology, including its integration into surfactant and delivery of the antioxidant Vitamin E to type II pneumocytes [Cholesterol synthesis is downregulated in critical illness by multiple mechanisms, including pro-inflammatory cytokines which affect transcription of cholesterol products [The present study investigates the effect of total cholesterol levels on response to statin therapy in ARDS using data from the SAILS and HARP-2 trials. First, we hypothesized that subjects with lower baseline cholesterol would have higher mortality than those with higher cholesterol, and second that randomization to statin therapy could be harmful in this high-risk subgroup.