Abstract
Background: Antipyretic treatments are common practices in intensive care. However, there is no enough understanding of the risk and benefit of antipyretic treatments in non-neurological critically ill patients. Methods: We have conducted a systematic review of the literature to assess the effect of antipyretic treatments on non-neurological critically ill patients. Results: Our literature search retrieved sixteen articles. Reviews of these articles revealed that: (1) Antipyretic effect among studies are largely variable; (2) The threshold body temperature for administration of antipyretic treatments are varied, although half of studies define it as 38.5°C; (3) Heart rate, minute ventilation and oxygen demand may decrease according to the temperature reduction using antipyretic treatments; (4) Antipyretic treatments using acetaminophen and non-steroidal anti-inflammatory drugs decrease blood pressure; (5) There is no studies to assess whether such a antipyretic effects improve patient-centered outcomes including morbidity, length of ICU stay and mortality. Conclusion: The reduction of respiratory and/or oxygen demand by using antipyretic treatments might be beneficial to some non-neurological critically ill cohorts. However, data on this area are insufficient to conclude their risk and benefit. There is an urgent need for randomized controlled study to determine optimal antipyretic strategies in non-neurological critically ill patients.
