[Acetaminophene-induced hypotension in intensive care unit: a prospective study].
OBJECTIVE
The aim of this study was to evaluate the incidence of paracetamol-induced hypotension in intensive care unit (ICU). The secondary end-point was the description of pathophysiologic phenomenon during this hypotension and risk factors.


METHODS
An observational study in three ICU of a French teaching hospital.


METHODS
All consecutives patients whom benefit from intravenous paracetamol administration were included in the study. When a 20% droop in arterial blood pressure occurred, plasma samples were obtained and tryptases were measured at 6 and 48 hours. Clinical, biological characteristics and paracetamol administration duration were prospectively monitored.


RESULTS
During a 2-months period, 127 ICU patients were included in the study with 1507 paracetamol administration. Twenty droops in arterial blood pressure were recorded in ICU. The incidence rate was 1.33%. Administration duration was 32+/-9 min. No respiratory nor cutaneous manifestations occurred during hypotensions. A specific treatment was administrated in half of the patients. Hypotension incidence was higher (3.9%) in patients with brain injury. Eighty percent of patients with hypotension have a severe sepsis or a septic shock.


CONCLUSIONS
In this cohort of ICU patients, hypotension incidence was higher than reported in drug legal mentions. Immunoallergic phenomenon was excluded. Brain injury and sepsis seems to be risk factors.
Mrozek
S
S
Service de réanimation adultes, pôle anesthésie-réanimation, Hôtel-Dieu, centre hospitalier universitaire de Clermont-Ferrand, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand cedex 1, France.
Constantin
J-M
JM
Futier
E
E
Zenut
M
M
Ghardes
G
G
Cayot-Constantin
S
S
Bonnard
M
M
Ait-Bensaid
N
N
Eschalier
A
A
Bazin
J-E
JE
D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology; D023381:Endpoint Determination; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000453:epidemiology; D007275:Injections, Intravenous; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000503:physiopathology; D012772:Shock, Septic / Q000150:complications / Q000503:physiopathology
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen