Acetaminophen for Fever in Critically Ill Patients with Suspected Infection
Paul Young, Manoj Saxena, Rinaldo Bellomo, Ross Freebairn, Naomi Hammond, Frank van Haren, Mark Holliday, Seton Henderson, Diane Mackle, Colin McArthur, Shay McGuinness, John Myburgh, Mark Weatherall, Steve Webb, Richard Beasley, HEAT Investigators, Australian and New Zealand Intensive Care Society Clinical Trials Group, Paul Young, Manoj Saxena, Rinaldo Bellomo, Ross Freebairn, Naomi Hammond, Frank van Haren, Mark Holliday, Seton Henderson, Colin McArthur, Shay McGuinness, Diane Mackle, John Myburgh, Mark Weatherall, Steve Webb, Richard Beasley, Jeffrey Lipman, Brian Anderson, Michael Bailey, Kerianne Cowdrey, Eileen Gilder, Lianne McCarthy, Shay McGuinness, Rachael Parke, Kirsten Benefield, Yan Chen, Colin McArthur, Rachael McConnochie, Lynette Newby, Rinaldo Bellomo, Glenn Eastwood, Leah Peck, Helen Young, Natasha Edmunds, Frank van Haren, Amy Harney, Katie Milburn, Mary Nourse, Sumeet Rai, Helen Rodgers, David Bowie, Neil Davidson, Alastair Gibson, Seton Henderson, Louise Hitchings, David Knight, Jan Mehrtens, Emmeline Minto, Matthew Morgan, Anna Morris, Sascha Noble, Geoffrey Shaw, Katherine Townend, Matthew Bailey, Dawn France, Robyn Hutchison, Llesley Chadwick, Ross Freebairn, Carmel Chapman, Andrew Stapleton, Teresa Thompson, Chantal Hogan, Alex Kazemi, Emmanuel Pelayo, Laura Rust, Rima Song, Judi Tai, Anna Tilsley, Tony Williams, Deepak Bhonagiri, Sharon Micallef, Ranganatha Ranggappa, Ritesh Sanghavi, Bruce King, Robyn Price, Sally Tollafield, Jeanette Bell, Danielle Hacking, Umit Holland, Ywain Lawrey, Olga Burgess, Graeme Duke, Angajendra Ghosh, Mary Park, Deborah Barge, Nerina Harley, Andrea Jordan, Christopher MacIsaac, Shyamala Sriram, Frances Bass, Simon Bird, Celia Bradford, Simon Finfer, Oliver Flower, Naomi Hammond, Anne O'Connor, Elizabeth Yarad, Heidi Buhr, Jennifer Coakley, David Gattas, Debra Hutch, Deborah Inskip, Jennene Miller, Manoj Saxena, Espedito Faraone, John Santamaria, Roger Smith, Antony Tobin, Serena Knowles, Priya Nair, Claire Reynolds, John Durning, Annette Forrest, Robert Frengley, Mary La Pine, Lynn Andrews, Ben Barry, Dick Dinsdale, Peter Hicks, Anna Hunt, Sally Hurford, Diane Mackle, Jessica Ongley, Chris Poynter, Alex Psirides, Shawn Sturland, Juliana Tang-Hickey, Bob Ure, Paul Young, Samantha Bates, Craig French, Forbes McGain, Anna Tippett, Miriam Towns, Wenli Geng, Bronwyn Johnson, Martin Sterba, Paul Young, Tanya Baker, Mark Holliday, Richard Beasley, Irene Braithwaite, Denise Fabian, Sally Hurford, Diane Mackle, Janine Pilcher, Alison Pritchard, Joanna Read, Maureen Stretch, Evan Tan, Manoj Saxena, Naomi Hammond, Maryam Correa, Parisa Glass, Ann Gould, Dijlah Hanna, John Myburgh, Sharon Micallef, Dorrilyn Rajbhandari, Paul Young, Manoj Saxena, Rinaldo Bellomo, Ross Freebairn, Naomi Hammond, Frank van Haren, Mark Holliday, Seton Henderson, Diane Mackle, Colin McArthur, Shay McGuinness, John Myburgh, Mark Weatherall, Steve Webb, Richard Beasley, HEAT Investigators, Australian and New Zealand Intensive Care Society Clinical Trials Group, Paul Young, Manoj Saxena, Rinaldo Bellomo, Ross Freebairn, Naomi Hammond, Frank van Haren, Mark Holliday, Seton Henderson, Colin McArthur, Shay McGuinness, Diane Mackle, John Myburgh, Mark Weatherall, Steve Webb, Richard Beasley, Jeffrey Lipman, Brian Anderson, Michael Bailey, Kerianne Cowdrey, Eileen Gilder, Lianne McCarthy, Shay McGuinness, Rachael Parke, Kirsten Benefield, Yan Chen, Colin McArthur, Rachael McConnochie, Lynette Newby, Rinaldo Bellomo, Glenn Eastwood, Leah Peck, Helen Young, Natasha Edmunds, Frank van Haren, Amy Harney, Katie Milburn, Mary Nourse, Sumeet Rai, Helen Rodgers, David Bowie, Neil Davidson, Alastair Gibson, Seton Henderson, Louise Hitchings, David Knight, Jan Mehrtens, Emmeline Minto, Matthew Morgan, Anna Morris, Sascha Noble, Geoffrey Shaw, Katherine Townend, Matthew Bailey, Dawn France, Robyn Hutchison, Llesley Chadwick, Ross Freebairn, Carmel Chapman, Andrew Stapleton, Teresa Thompson, Chantal Hogan, Alex Kazemi, Emmanuel Pelayo, Laura Rust, Rima Song, Judi Tai, Anna Tilsley, Tony Williams, Deepak Bhonagiri, Sharon Micallef, Ranganatha Ranggappa, Ritesh Sanghavi, Bruce King, Robyn Price, Sally Tollafield, Jeanette Bell, Danielle Hacking, Umit Holland, Ywain Lawrey, Olga Burgess, Graeme Duke, Angajendra Ghosh, Mary Park, Deborah Barge, Nerina Harley, Andrea Jordan, Christopher MacIsaac, Shyamala Sriram, Frances Bass, Simon Bird, Celia Bradford, Simon Finfer, Oliver Flower, Naomi Hammond, Anne O'Connor, Elizabeth Yarad, Heidi Buhr, Jennifer Coakley, David Gattas, Debra Hutch, Deborah Inskip, Jennene Miller, Manoj Saxena, Espedito Faraone, John Santamaria, Roger Smith, Antony Tobin, Serena Knowles, Priya Nair, Claire Reynolds, John Durning, Annette Forrest, Robert Frengley, Mary La Pine, Lynn Andrews, Ben Barry, Dick Dinsdale, Peter Hicks, Anna Hunt, Sally Hurford, Diane Mackle, Jessica Ongley, Chris Poynter, Alex Psirides, Shawn Sturland, Juliana Tang-Hickey, Bob Ure, Paul Young, Samantha Bates, Craig French, Forbes McGain, Anna Tippett, Miriam Towns, Wenli Geng, Bronwyn Johnson, Martin Sterba, Paul Young, Tanya Baker, Mark Holliday, Richard Beasley, Irene Braithwaite, Denise Fabian, Sally Hurford, Diane Mackle, Janine Pilcher, Alison Pritchard, Joanna Read, Maureen Stretch, Evan Tan, Manoj Saxena, Naomi Hammond, Maryam Correa, Parisa Glass, Ann Gould, Dijlah Hanna, John Myburgh, Sharon Micallef, Dorrilyn Rajbhandari
Abstract
Background: Acetaminophen is a common therapy for fever in patients in the intensive care unit (ICU) who have probable infection, but its effects are unknown.
Methods: We randomly assigned 700 ICU patients with fever (body temperature, ≥38°C) and known or suspected infection to receive either 1 g of intravenous acetaminophen or placebo every 6 hours until ICU discharge, resolution of fever, cessation of antimicrobial therapy, or death. The primary outcome was ICU-free days (days alive and free from the need for intensive care) from randomization to day 28.
Results: The number of ICU-free days to day 28 did not differ significantly between the acetaminophen group and the placebo group: 23 days (interquartile range, 13 to 25) among patients assigned to acetaminophen and 22 days (interquartile range, 12 to 25) among patients assigned to placebo (Hodges-Lehmann estimate of absolute difference, 0 days; 96.2% confidence interval [CI], 0 to 1; P=0.07). A total of 55 of 345 patients in the acetaminophen group (15.9%) and 57 of 344 patients in the placebo group (16.6%) had died by day 90 (relative risk, 0.96; 95% CI, 0.66 to 1.39; P=0.84).
Conclusions: Early administration of acetaminophen to treat fever due to probable infection did not affect the number of ICU-free days. (Funded by the Health Research Council of New Zealand and others; HEAT Australian New Zealand Clinical Trials Registry number, ACTRN12612000513819.).
Source: PubMed