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Temperature control in critically ill patients with fever: A meta-analysis of randomized controlled trials.

Abstract：

PURPOSE:Fever is frequently encountered in ICU. It is unclear if targeted temperature control is beneficial in critically ill patients with suspected or confirmed infection. We conducted a systemic review and meta-analysis to answer this question. METHODS:We systematically reviewed major databases before January 2020 to identify randomized controlled trials (RCTs) that compared antipyretic with placebo for temperature control in non-neurocritical ill adult patients with suspected or confirmed infection. Outcomes of interest were 28-day mortality, temperature level, hospital mortality, length of stay, shock reversal, and patient comfort. RESULT:13 RCTs enrolling 1963 patients were included. No difference in 28-day mortality between antipyretic compared with placebo (risk ratio [RR] 1.03; 95% CI 0.79-1.35). Lower temperature levels were achieved in the antipyretic group (MD [mean difference] -0.41; 95% CI -0.66 to -0.16). Antipyretic use did not affect the risk of hospital mortality (RR 0.97; 95% CI 0.73-1.30), ICU length of stay (MD -0.07; 95% CI -0.70 to 0.56), or shock reversal (RR 1.11; 95% CI 0.76-1.62). CONCLUSION:Antipyretic therapy effectively reduces temperature in non-neurocritical ill patients but does not reduce mortality or impact other outcomes.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Sakkat A,Alquraini M,Aljazeeri J,Farooqi MAM,Alshamsi F,Alhazzani W

doi

10.1016/j.jcrc.2020.10.016

subject

Has Abstract

pub_date

2021-02-01 00:00:00

pages

89-95

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(20)30737-1

journal_volume

61

pub_type

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