fever, friend or foe? - paul young's talk at smacc

Fever: friend or foe?Paul Young

ICU Specialist, Wellington Hospital, NZ

Fever: friend or foe?

Fever is one of the

cardinal signs of infection

Why doesn’t Campylobacter make chickens sick?

Kluger MJ, Ringler DH, Anver MR. Fever and survival.

Science 1975;188:166-8.

Neurosyphilis resolves after febrile illness Malaria

causes a fever

Does Malaria cure syphilis?

n=269,078

antipyretics physical cooling

n= 689

permissive vs. aggressive temperature management

febrile ICU patients with infectionsfebrile ICU patients with infections

?

friend or foe

DesignDesign• Multi-centreMulti-centre

- 22 sites in Australia and New Zealand - 22 sites in Australia and New Zealand

• RandomisedRandomised• Double-blindDouble-blind• Placebo-controlledPlacebo-controlled• Phase 2 trialPhase 2 trial

N= 700 patientsN= 700 patients

•PatientsPatients– ICU patients with fever + infectionICU patients with fever + infection

• InterventionIntervention– Intravenous paracetamol vs. placeboIntravenous paracetamol vs. placebo

•OutcomeOutcome– ICU free days at day 28ICU free days at day 28