A Simon1,2, A Leffler3. 1. Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland. psychosomatik.simon@googlemail.com. 2. , Hannover, Deutschland. psychosomatik.simon@googlemail.com. 3. Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland.
Abstract
BACKGROUND: Antipyretics are among the most widely prescribed drugs in German hospitals. Despite this widespread use, their role for treatment of critically ill patients still remains unclear. In particular, the questionable positive effects of reducing fever are discussed. OBJECTIVES: In this review we aimed to summarize and discuss current study results covering the use of antipyretics in critically ill patients. Suspected effects with regard to fever reduction and lethality should be considered. MATERIALS AND METHODS: A selective literature search was carried out in the PubMed database. We reviewed the bibliographies of all work considered relevant. RESULTS: There are only a few studies on the use of antipyretics in intensive care patients, which are difficult to compare systematically due to different designs, protocols and endpoints. All in all, the decrease in temperature was very low (0.3 °C) and showed even adverse effects on 28-days mortality in sepsis. In patients with sepsis and ASS medication, a decreased mortality has been shown in retrospective analysis. CONCLUSIONS: The benefit of fever control using antipyretics in intensive care patients with regard to endpoints like lethality remains unclear. Randomized controlled trials with suitable protocols and endpoints are needed to provide a solid base for development of guidelines.
BACKGROUND: Antipyretics are among the most widely prescribed drugs in German hospitals. Despite this widespread use, their role for treatment of critically illpatients still remains unclear. In particular, the questionable positive effects of reducing fever are discussed. OBJECTIVES: In this review we aimed to summarize and discuss current study results covering the use of antipyretics in critically illpatients. Suspected effects with regard to fever reduction and lethality should be considered. MATERIALS AND METHODS: A selective literature search was carried out in the PubMed database. We reviewed the bibliographies of all work considered relevant. RESULTS: There are only a few studies on the use of antipyretics in intensive care patients, which are difficult to compare systematically due to different designs, protocols and endpoints. All in all, the decrease in temperature was very low (0.3 °C) and showed even adverse effects on 28-days mortality in sepsis. In patients with sepsis and ASS medication, a decreased mortality has been shown in retrospective analysis. CONCLUSIONS: The benefit of fever control using antipyretics in intensive care patients with regard to endpoints like lethality remains unclear. Randomized controlled trials with suitable protocols and endpoints are needed to provide a solid base for development of guidelines.
Authors: Shantel A Vital; Felix Becker; Paul M Holloway; Janice Russell; Mauro Perretti; D Neil Granger; Felicity N E Gavins Journal: Circulation Date: 2016-05-06 Impact factor: 29.690
Authors: Gordon Philipp Otto; Maik Sossdorf; Janina Boettel; Björn Kabisch; Hannes Breuel; Johannes Winning; Wolfgang Lösche Journal: Platelets Date: 2012-09-20 Impact factor: 3.862
Authors: Heleen M den Hertog; H Bart van der Worp; H Maarten A van Gemert; Ale Algra; L Jaap Kappelle; Jan van Gijn; Peter J Koudstaal; Diederik W J Dippel Journal: J Neurol Date: 2010-09-30 Impact factor: 4.849