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Title: Acetaminophen for fever in critically ill patients with suspected infection
Austin Authors: Young, P;Saxena, M;Bellomo, Rinaldo ;Freebairn, R;Hammond, N;van Haren, F;Holliday, M;Henderson, S;Mackle, D;McArthur, C;McGuinness, S;Myburgh, J;Weatherall, M;Webb, S;Beasley, R;HEAT Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group
Affiliation: Intensive Care Unit, Wellington Regional Hospital
Medical Research Institute of New Zealand
Wellington School of Medicine, University of Otago
Intensive Care Unit, Hawke's Bay Hospital, Hastings
Christchurch Hospital, Christchurch
Auckland City Hospital
Critical Care and Trauma Division, George Institute for Global Health, Sydney
Intensive Care Unit, St. George Hospital, Kogarah
Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St. Leonards
Faculty of Medicine, St. George Clinical School, University of New South Wales, Kensington, NSW
Intensive Care Unit, Austin Hospital
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University
Faculty of Medicine, University of Melbourne
Intensive Care Unit, Canberra Hospital, Canberra, ACT
Intensive Care Unit, Royal Perth Hospital, Perth
School of Medicine and Pharmacology, University of Western Australia, Crawley
Issue Date: 3-Dec-2015
Date: 2015-10-05
Publication information: The New England Journal of Medicine 2015; 373(23): 2215-2224
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 .).
Journal: The New England Journal of Medicine
PubMed URL:
Type: Journal Article
Subjects: Acetaminophen
Intensive Care Units
Type of Clinical Study or Trial: Clinical Trial
Appears in Collections:Journal articles

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