Effects of IV Acetaminophen on Core Body Temperature and Hemodynamic Responses in Febrile Critically Ill Adults: A Randomized Controlled Trial.
Crit Care Med
; 45(7): 1199-1207, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28319467
ABSTRACT
OBJECTIVE:
To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients.DESIGN:
Randomized, double-blind, placebo-controlled clinical trial.SETTING:
Three adult ICUs at a large, urban, academic medical center. PATIENTS Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION An infusion of acetaminophen 1 g or saline placebo over 15 minutes. MEASUREMENT AND MAINRESULTS:
Core temperature and vital signs were measured at baseline and at 5-15-minute intervals for 4 hours after infusion of study drug. The primary outcome was time-weighted average core temperature adjusted for baseline temperature. Secondary outcomes included adjusted time-weighted average heart rate, blood pressure, and respiratory rate, along with changes-over-time for each. Baseline patient characteristics were similar in those given acetaminophen and placebo. Patients given acetaminophen had an adjusted time-weighted average temperature that was 0.47°C less than those given placebo (95% CI, -0.76 to -0.18; p = 0.002). The acetaminophen group had significantly lower adjusted time-weighted average systolic blood pressure (-17 mm Hg; 95% CI, -25 to -8; p < 0.001), mean arterial pressure (-7 mm Hg; 95% CI, -12 to -1; p = 0.02), and heart rate (-6 beats/min; 95% CI, -10 to -1; p = 0.03). Changes-over-time temperature, blood pressure, and heart rate outcomes were also significantly lower at 2 hours, but not at 4 hours.CONCLUSIONS:
Among febrile critically ill adults, treatment with acetaminophen decreased temperature, blood pressure, and heart rate. IV acetaminophen thus produces modest fever reduction in critical care patients, along with clinically important reductions in blood pressure.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estado Terminal
/
Febre
/
Acetaminofen
Tipo de estudo:
Clinical_trials
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Crit Care Med
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Canadá