Problem No The evidence for this recommendation comes from one study (Needham et al Is there a ○ problem Probably no 2016) : a randomized double blind, placebo controlled of 272 ○ priority? Uncertain patients in Medical ICUs at 35 US hospitals randomized to rosuvastatin (40 ○ Probably yes mg loading dose and 20 mg daily until 3 days after discharge from the ○ Yes ICU) or placebo -Inclusion CRITERIA: patients with ARDS; receiving ● Mechanical Ventilation through an endotracheal tube; meeting SIRS criteria with a known or suspected infection; EXCLUSION CRITERIA: ARDS > 48 hours, Pre-Existing condition adversely affecting survival or weaning from Mech Vent; receiving statins within 48 hours of randomization; > 5X's CK, AST, ALT; SPECIFIC to COGNITIVE OUTCOMES ADDITIONAL EXCLUSIONS WERE< 18 years of age; non-English speakers; Homeless; pre-existing cognitive impairment. Benefits & What is the No included studies ○ harms of the overall Very low The relative ○ options certainty of Low ○ this evidence? Moderate ● High ○ Is there Important uncertainty or variability ○ Possibly important uncertainty or important ○ uncertainty variability about how Probably no important uncertainty or ● much people variability
Problem Is there a problem priority? ○ No ○ Probably no ○ Uncertain ○ Probably yes ● Yes The evidence for this recommendation comes from one study (Needham et al 2016) : a randomized double blind, placebo controlled of 272 patients in Medical ICUs at 35 US hospitals randomized to rosuvastatin (40 mg loading dose and 20 mg daily until 3 days after discharge from the ICU) or placebo -Inclusion CRITERIA: patients with ARDS; receiving Mechanical Ventilation through an endotracheal tube; meeting SIRS criteria with a known or suspected infection; EXCLUSION CRITERIA: ARDS > 48 hours, Pre-Existing condition adversely affecting survival or weaning from Mech Vent; receiving statins within 48 hours of randomization; > 5X's CK, AST, ALT; SPECIFIC to COGNITIVE OUTCOMES ADDITIONAL EXCLUSIONS WERE< 18 years of age; non-English speakers; Homeless; pre-existing cognitive impairment. Benefits & harms of the options What is the overall certainty of this evidence? ○ No included studies ○ Very low ○ Low ● Moderate ○ High The relative Is there important uncertainty about how much people ○ Important uncertainty or variability ○ Possibly important uncertainty or variability ● Probably no important uncertainty or variability
CCM_46_9_2018_06_08_DEVLIN_CCMED-D-18-00069_SDC26.docx