fever, friend or foe? - paul young's talk at smacc
DESCRIPTION
LITFL's Paul Young looks at the evidence for and against a beneficial role for fever in the critically ill in this whimsical and erudite walk through medical history and science. For audio go here: https://gmep.org/media/14605TRANSCRIPT
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
