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Antipyretic

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Richard Fagley – One of the best experts on this subject based on the ideXlab platform.

  • early Antipyretic exposure does not increase mortality in patients with gram negative severe sepsis a retrospective cohort study
    Internal and Emergency Medicine, 2012
    Co-Authors: Nicholas M Mohr, Brian M Fuller, Lee P Skrupky, Robert Alunday, Scott T Micek, Michael Wallendorf, Richard Fagley

    Abstract:

    Existing data suggest that Antipyretic medications may have deleterious effects on immune function and may increase mortality in human infection. This study was designed to evaluate the impact of Antipyretic therapy on 28-day in-hospital mortality when administered early in the course of gram-negative severe sepsis or septic shock. This study was a single-center retrospective cohort study at a 1,111-bed academic medical center of all febrile patients with gram-negative bacteremia hospitalized with severe sepsis or septic shock (n = 278) between Jan 2002 and Feb 2008. Although the raw mortality was lower in the group that received an early Antipyretic medication (22 vs. 35 %, p = 0.01), patients in the early Antipyretic group had higher mean arterial pressure (58.0 vs. 52.7, p = 0.01) and higher 24-h T max (39.3 vs. 39.0, p < 0.01). Early Antipyretic therapy was not significantly associated with 28-day in-hospital mortality (adjusted OR 0.55, 0.29–1.03) in a multivariable logistic regression model controlling for APACHE-II score, hypotension, pneumonia, surgery during hospitalization, persistent fever, and in-hospital dialysis. In conclusion, early Antipyretic therapy is not associated with increased mortality.

  • clinical and demographic factors associated with Antipyretic use in gram negative severe sepsis and septic shock
    Annals of Pharmacotherapy, 2011
    Co-Authors: Nicholas M Mohr, Brian M Fuller, Lee P Skrupky, Robert Alunday, Scott T Micek, Richard Fagley

    Abstract:

    Background:Antipyretic therapy is commonly prescribed for patients with Infection, but studies of its impact on clinical outcomes have yielded mixed results. No data exist to characterize the use of Antipyretic medications in patients with severe sepsis or septic shock.Objective:To identify clinical and demographic factors associated with Antipyretic medication administration in severe sepsis and septic shock.Methods:This single-center, retrospective, cohort study assessed febrile patients [temperature ≥38.3°C) with gram-negative severe sepsis or septic shock at an 1111-bed academic medical center between January 2002 and February 2008, Patients were excluded if they had liver disease, acute brain injury, or allergy to acetaminophen. Generalized estimating equations were used to estimate the effect of clinical factors on treatment of patients with Antipyretic medications,Results:Although 76% of patients in this febrile cohort (n = 241) were prescribed an Antipyretic agent, only 42% received Antipyretic th…

Brian M Fuller – One of the best experts on this subject based on the ideXlab platform.

  • the association of fever and Antipyretic medication with outcomes in mechanically ventilated patients a cohort study
    Shock, 2019
    Co-Authors: Emily Evans, Brian M Fuller, Rebecca J Doctor, Brian F Gage, Richard S Hotchkiss, Anne M Drewry

    Abstract:

    BACKGROUND Fever is common in mechanically ventilated patients and may be uniquely detrimental in those with lung injury because of its injurious effects on pulmonary vascular permeability and alveolar epithelium. We evaluated the association of fever and Antipyretic medication with mortality in mechanically ventilated emergency department (ED) patients. METHODS This is a retrospective cohort study of 1,264 patients requiring mechanical ventilation initiated in the ED with subsequent admission to an intensive care unit. Maximum body temperature was recorded for the first 24 h after ED admission and categorized into four categories: <37°C, 37°C to 38.2°C, 38.3°C to 39.4°C, and ≥39.5°C. The primary outcome was 28-day mortality. We conducted a planned subgroup analysis of patients with sepsis at the time of intubation. Multivariable Cox proportional hazard ratios (HRs) were used to assess the relationship between temperature, Antipyretics, and mortality. RESULTS Multivariable Cox proportional HRs demonstrated that a maximum temperature ≥39.5°C was associated with increased mortality (adjusted hazard ratio [aHR] 1.59 [95% confidence interval, CI, 1.05-2.39]). In the subgroup of patients with sepsis, a maximum temperature of 38.3°C to 39.4°C was associated with survival (aHR 0.61 [95% CI, 0.39-0.99]). There was no difference in 28-day mortality between patients who did and did not receive Antipyretic medication in either the overall cohort or the septic subgroup. CONCLUSION High fever (≥39.5°C) was associated with increased risk for mortality in mechanically ventilated patients. However, in patients with sepsis, moderate fever (38.3°C-39.4°C) was protective. Antipyretic medication was not associated with changes in outcome. This suggests that fever may have different implications in septic versus nonseptic mechanically ventilated patients.

  • early Antipyretic exposure does not increase mortality in patients with gram negative severe sepsis a retrospective cohort study
    Internal and Emergency Medicine, 2012
    Co-Authors: Nicholas M Mohr, Brian M Fuller, Lee P Skrupky, Robert Alunday, Scott T Micek, Michael Wallendorf, Richard Fagley

    Abstract:

    Existing data suggest that Antipyretic medications may have deleterious effects on immune function and may increase mortality in human infection. This study was designed to evaluate the impact of Antipyretic therapy on 28-day in-hospital mortality when administered early in the course of gram-negative severe sepsis or septic shock. This study was a single-center retrospective cohort study at a 1,111-bed academic medical center of all febrile patients with gram-negative bacteremia hospitalized with severe sepsis or septic shock (n = 278) between Jan 2002 and Feb 2008. Although the raw mortality was lower in the group that received an early Antipyretic medication (22 vs. 35 %, p = 0.01), patients in the early Antipyretic group had higher mean arterial pressure (58.0 vs. 52.7, p = 0.01) and higher 24-h T max (39.3 vs. 39.0, p < 0.01). Early Antipyretic therapy was not significantly associated with 28-day in-hospital mortality (adjusted OR 0.55, 0.29–1.03) in a multivariable logistic regression model controlling for APACHE-II score, hypotension, pneumonia, surgery during hospitalization, persistent fever, and in-hospital dialysis. In conclusion, early Antipyretic therapy is not associated with increased mortality.

  • clinical and demographic factors associated with Antipyretic use in gram negative severe sepsis and septic shock
    Annals of Pharmacotherapy, 2011
    Co-Authors: Nicholas M Mohr, Brian M Fuller, Lee P Skrupky, Robert Alunday, Scott T Micek, Richard Fagley

    Abstract:

    Background:Antipyretic therapy is commonly prescribed for patients with Infection, but studies of its impact on clinical outcomes have yielded mixed results. No data exist to characterize the use of Antipyretic medications in patients with severe sepsis or septic shock.Objective:To identify clinical and demographic factors associated with Antipyretic medication administration in severe sepsis and septic shock.Methods:This single-center, retrospective, cohort study assessed febrile patients [temperature ≥38.3°C) with gram-negative severe sepsis or septic shock at an 1111-bed academic medical center between January 2002 and February 2008, Patients were excluded if they had liver disease, acute brain injury, or allergy to acetaminophen. Generalized estimating equations were used to estimate the effect of clinical factors on treatment of patients with Antipyretic medications,Results:Although 76% of patients in this febrile cohort (n = 241) were prescribed an Antipyretic agent, only 42% received Antipyretic th…

Nicholas M Mohr – One of the best experts on this subject based on the ideXlab platform.

  • early Antipyretic exposure does not increase mortality in patients with gram negative severe sepsis a retrospective cohort study
    Internal and Emergency Medicine, 2012
    Co-Authors: Nicholas M Mohr, Brian M Fuller, Lee P Skrupky, Robert Alunday, Scott T Micek, Michael Wallendorf, Richard Fagley

    Abstract:

    Existing data suggest that Antipyretic medications may have deleterious effects on immune function and may increase mortality in human infection. This study was designed to evaluate the impact of Antipyretic therapy on 28-day in-hospital mortality when administered early in the course of gram-negative severe sepsis or septic shock. This study was a single-center retrospective cohort study at a 1,111-bed academic medical center of all febrile patients with gram-negative bacteremia hospitalized with severe sepsis or septic shock (n = 278) between Jan 2002 and Feb 2008. Although the raw mortality was lower in the group that received an early Antipyretic medication (22 vs. 35 %, p = 0.01), patients in the early Antipyretic group had higher mean arterial pressure (58.0 vs. 52.7, p = 0.01) and higher 24-h T max (39.3 vs. 39.0, p < 0.01). Early Antipyretic therapy was not significantly associated with 28-day in-hospital mortality (adjusted OR 0.55, 0.29–1.03) in a multivariable logistic regression model controlling for APACHE-II score, hypotension, pneumonia, surgery during hospitalization, persistent fever, and in-hospital dialysis. In conclusion, early Antipyretic therapy is not associated with increased mortality.

  • clinical and demographic factors associated with Antipyretic use in gram negative severe sepsis and septic shock
    Annals of Pharmacotherapy, 2011
    Co-Authors: Nicholas M Mohr, Brian M Fuller, Lee P Skrupky, Robert Alunday, Scott T Micek, Richard Fagley

    Abstract:

    Background:Antipyretic therapy is commonly prescribed for patients with Infection, but studies of its impact on clinical outcomes have yielded mixed results. No data exist to characterize the use of Antipyretic medications in patients with severe sepsis or septic shock.Objective:To identify clinical and demographic factors associated with Antipyretic medication administration in severe sepsis and septic shock.Methods:This single-center, retrospective, cohort study assessed febrile patients [temperature ≥38.3°C) with gram-negative severe sepsis or septic shock at an 1111-bed academic medical center between January 2002 and February 2008, Patients were excluded if they had liver disease, acute brain injury, or allergy to acetaminophen. Generalized estimating equations were used to estimate the effect of clinical factors on treatment of patients with Antipyretic medications,Results:Although 76% of patients in this febrile cohort (n = 241) were prescribed an Antipyretic agent, only 42% received Antipyretic th…