A Prospective Randomized Study to Evaluate the Antipyretic Effect of the Combination of Acetaminophen and Ibuprofen in Neurological ICU Patients

作者：Mullins Michael E; Empey Matthew; Jaramillo David; Sosa Sameta^*; Human Theresa; Diringer Michael N

来源：Neurocritical Care, 2011, 15(3): 375-378.

DOI：10.1007/s12028-011-9533-8

• Fever
• Acetaminophen
• Ibuprofen

To compare the antipyretic effect of simultaneously administered acetaminophen (APAP) plus ibuprofen (IBU) to either APAP or IBU alone in critically ill febrile neurological and neurosurgical patients.
This is a prospective, three-armed, randomized controlled trial of 79 patients in the neurology/neurosurgery intensive care unit (NNICU) of a tertiary care academic hospital. Eligible patients who developed a temperature a parts per thousand yen38A degrees C were randomized to receive either a single dose of APAP 975 mg, a single dose of IBU 800 mg, or a combination of both (APAP + IBU). Oral temperatures were measured hourly for 6 h following medication administration.
All three treatments decreased temperature over the 6-h period. The area under the curve (AUC) for Delta T for APAP was -3.55A degrees C-h (95% CI -4.75 to -2.34A degrees C-h); for IBU was -4.05A degrees C-h (95% CI -5.16 to -2.94A degrees C-h); and for the combination of APAP and IBU was -5.10A degrees C-h (95% CI -6.20 to -4.01A degrees C-h). The differences in AUC between the groups were as follows: IBU versus APAP = -0.50A degrees C-h (P = 0.28), APAP + IBU versus IBU = -1.05A degrees C-h (P = 0.09), and APAP + IBU versus APAP = -1.56A degrees C-h (P = 0.03).
The combination of IBU and APAP produces significantly greater fever control than APAP alone, with trends favoring the combination over IBU alone and IBU over APAP alone.

• 出版日期2011-12