title: [Hemodynamic and antipyretic effects of paracetamol, metamizol and dexketoprofen in critical patients].
abstract: BACKGROUND
  The objective was to study the antipyretic and hemodynamic effects of three different drugs used to treat fever in critically ill patients.
  
  
  METHODS
  
  
  
  METHODS
  Prospective, observational study in a 16-bed, general ICU of a university hospital.
  
  
  METHODS
  We studied 150 patients who had a febrile episode (temperature>38°C): 50 received paracetamol, 50 metamizol and 50 dexketoprofen.
  
  
  METHODS
  None. Body temperature, systolic, diastolic and mean arterial pressure, heart rate, central venous pressure and oxygen saturation were determined at baseline and at 30, 60 and 120minutes after infusion of the drug. Additionally, we recorded temperature 180minutes after starting drug infusion. Diuresis and the need for or change of dose of vasodilator or vasoconstrictor drugs were also recorded.
  
  
  RESULTS
  Patient characteristics, baseline temperature and hemodynamics were similar in all groups. We observed a significant decrease of at least 1°C in temperature after 180minutes in 38 patients treated with dexketoprofen (76%), in 36 with metamizol (72%), and in 20 with paracetamol (40%) (p<0.001). After 120minutes, the mean decrease in mean arterial pressure was 8.5±13.6mmHg with paracetamol, 14.9±11.8mmHg with metamizol, and 16.8±13.7mmHg with dexketoprofen (p=0.005).
  
  
  CONCLUSIONS
  Dexketoprofen was the most effective antipyretic agent at the doses tested. Although all three drugs reduced mean arterial pressure, the reduction with paracetamol was less pronounced.
authors.affiliation: Unidad de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España. pvera@santpau.cat
authors.forename: P
authors.initials: P
authors.lastname: Vera
authors.forename: L
authors.initials: L
authors.lastname: Zapata
authors.forename: I
authors.initials: I
authors.lastname: Gich
authors.forename: J
authors.initials: J
authors.lastname: Mancebo
authors.forename: A J
authors.initials: AJ
authors.lastname: Betbesé
mesh_terms: D000082:Acetaminophen / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology* / Q000627:therapeutic use; D058633:Antipyretics / Q000494:pharmacology* / Q000627:therapeutic use; D016638:Critical Illness; D004177:Dipyrone / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007660:Ketoprofen / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014325:Tromethamine / Q000494:pharmacology* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D058633:Antipyretics; D014325:Tromethamine; D000082:Acetaminophen; D004177:Dipyrone; D007660:Ketoprofen; C118296:dexketoprofen trometamol