Angiotensin Converting Enzyme Inhibitor Use is associated with improved in-hospital Survival among Intensive Care Unit Patients with Blood Borne Infections

Tuesday, September 23, 2014 — Poster Session III
12:00 p.m. – 2:00 p.m.	FAES Academic Center	NLM	CLIN-10

* FARE Award Winner

Authors

• J Kimbrough
• V Huser
• J Cimino

Abstract

Among intensive care unit (ICU) patients, blood borne infections are associated with potential complications such as sepsis, systemic inflammatory response syndrome and other sequelae such as endocarditis. Antimicrobials are often employed; additionally, therapy directed at the vascular pathophysiology may also be used. For example, vasopressors can be prescribed in hypotensive patients. Also, beta-blockers, despite their hypotensive effects, have been also been associated with improved survival among intensive care unit patients with a variety of conditions including sepsis (possibly by blunting an excessive catecholamine response). It is unclear if other anti-hypertensive drugs, such as angiotensin converting enzyme inhibitors (ACEIs) provide a similar benefit, likely through a different mechanism. To explore the effect of ACEIs on ICU patients with blood borne infections, we performed a retrospective, cohort study on a population of ICU patients with blood borne infections in the Multiparameter Intelligent Monitoring in Intensive Care Unit (MIMIC-II) database. MIMIC-II is a publicly accessible repository of de-identified ICU clinical data from more than 32,000 patients. Initial analysis of 2,974 infected ICU patients demonstrates an in-hospital survival benefit among those exposed to ACEI inhibitors during their admission (Odds Ratio 0.67).

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