Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20327
Title: Fever control in critically ill adults. An individual patient data meta-analysis of randomised controlled trials.
Austin Authors: Young, Paul J;Bellomo, Rinaldo ;Bernard, Gordon R;Niven, Daniel J;Schortgen, Frederique;Saxena, Manoj;Beasley, Richard;Weatherall, Mark
Affiliation: Vanderbilt University Medical Center, Nashville, TN, USA
Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
Adult Intensive Care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France
Medical Research Institute of New Zealand, Wellington, New Zealand.
The George Institute for Global Health, Sydney, Australia
Bankstown Hospital, University of New South Wales, South Western Sydney Local Health District, Sydney, NSW, Australia
Austin Health, Heidelberg, Victoria, Australia
University of Otago, Wellington, New Zealand
Medical Research Institute of New Zealand, Wellington, New Zealand
Intensive Care Unit, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
Issue Date: Apr-2019
metadata.dc.date: 2019-02-11
Publication information: Intensive Care Medicine 2019; 45(4): 468-476
Abstract: One potential way to protect patients from the physiological demands that are a consequence of fever is to aim to prevent fever and to treat it assiduously when it occurs. Our primary hypothesis was that more active fever management would increase survival among patient subgroups with limited physiological reserves such as older patients, patients with higher illness acuity, and those requiring organ support. We conducted an individual-level patient data meta-analysis of randomised controlled trials to compare the outcomes of ICU patients who received more active fever management with the outcomes of patients who received less active fever management. The primary outcome variable of interest was the unadjusted time to death after randomisation. Of 1413 trial participants, 707 were assigned to more active fever management and 706 were assigned to less active fever management. There was no statistically significant heterogeneity in the effect of more active compared with less active fever management on survival in any of the pre-specified subgroups that were chosen to identify patients with limited physiological reserves. Overall, more active fever management did not result in a statistically significant difference in survival time compared with less active fever management [hazard ratio 0.91; (95% CI 0.75-1.10), P = 0.32]. Our findings do not support the hypothesis that more active fever management increases survival compared with less active fever management overall or in patients with limited physiological reserves.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20327
DOI: 10.1007/s00134-019-05553-w
ORCID: 0000-0002-3428-3083
0000-0002-1650-8939
PubMed URL: 30741326
Type: Journal Article
Subjects: Fever
Non-steroidal anti-inflammatory drugs
Paracetamol
Physical cooling
Sepsis
Septic shock
Appears in Collections:Journal articles

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