TY - JOUR
T1 - Acetaminophen for fever in critically iII patients with suspected infection
AU - Young, Paul
AU - Saxena, Manoj
AU - Bellomo, Rinaldo
AU - Freebairn, Ross
AU - Hammond, Naomi
AU - van Haren, Frank
AU - Holliday, Mark
AU - Henderson, Seton
AU - Mackle, Diane
AU - McArthur, Colin
AU - McGuinness, Shay
AU - Myburgh, John
AU - Weatherall, Mark
AU - Webb, Steve
AU - Beasley, Richard
AU - HEAT Investigators
AU - Bhonagiri, Deepak
AU - Australia and New Zealand Intensive Care Society Clinical Trials Group
PY - 2015/12/3
Y1 - 2015/12/3
N2 - 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 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.).
AB - 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 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.).
UR - http://www.scopus.com/inward/record.url?scp=84948844052&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa1508375
DO - 10.1056/NEJMoa1508375
M3 - Article
C2 - 26436473
AN - SCOPUS:84948844052
VL - 373
SP - 2215
EP - 2224
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 23
ER -