• S Mrozek, J-M Constantin, E Futier, M Zenut, G Ghardes, S Cayot-Constantin, M Bonnard, N Ait-Bensaid, A Eschalier, and J-E Bazin.
• Service de réanimation adultes, pôle anesthésie-réanimation, Hôtel-Dieu, centre hospitalier universitaire de Clermont-Ferrand, boulevard Léon-Malfreyt, 63058 Clermont-Ferrand cedex 1, France.
• Ann Fr Anesth Reanim. 2009 May 1; 28 (5): 448-53.

ObjectivesThe 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.Study DesignAn observational study in three ICU of a French teaching hospital.Patients And MethodsAll 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.ResultsDuring 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.ConclusionIn 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.

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