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Fever, Friend or Foe? - Paul Young's Talk at SMACC


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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:

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Fever, Friend or Foe? - Paul Young's Talk at SMACC

  1. 1. Fever: friend or foe? Paul Young ICU Specialist, Wellington Hospital, NZ
  2. 2. Fever: friend or foe?
  3. 3. Fever is one of the cardinal signs of
  4. 4. Why doesn’t Campylobacter make chickens sick?
  5. 5. Kluger MJ, Ringler DH, Anver MR. Fever and survival. Science 1975;188:166-8.
  6. 6. Neurosyphilis resolves after febrile illness Malaria causes a fever Does Malaria cure syphilis?
  7. 7. n=269,078
  8. 8. antipyretics physical cooling
  9. 9. n= 689
  10. 10. permissive vs. aggressive temperature management
  11. 11. febrile ICUfebrile ICU patients withpatients with infectionsinfections ? friend or foe
  12. 12. DesignDesign • Multi-centreMulti-centre - 22 sitesin Australiaand New Zealand- 22 sitesin Australiaand New Zealand • RandomisedRandomised • Double-blindDouble-blind • Placebo-controlledPlacebo-controlled • Phase2 trialPhase2 trial N= 700 patientsN= 700 patients
  13. 13. •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