The use or misuse of statins in critically ill patients recently attracted the 
attention of intensive care clinicians. Indeed, statins are probably the most 
common chronic treatment before critical illness and some recent experimental 
and clinical data demonstrated their beneficial effects during sepsis, acute 
lung injury (ALI)/acute respiratory distress syndrome (ARDS), or after 
aneurismal subarachnoidal hemorrhage (aSAH). Due to the heterogeneity of current 
studies and the lack of well-designed prospective studies, definitive 
conclusions for systematic and large-scale utilization in intensive care units 
cannot be drawn from the published evidence. Furthermore, the extent of statins 
side effects in critically ill patients is still unknown. For the intensive care 
clinician, it is a matter of individually identifying the patient who can 
benefit from this therapy according to the current literature. The purpose of 
this review is to describe the mechanisms of actions of statins and to 
synthesize the clinical data that underline the relevant effects of statins in 
the particular setting of critical care, in an attempt to guide the clinician 
through his daily practice.