Aim: Studies in adults have reported high rates of hypotension following intravenous paracetamol administration. We aimed to investigate the hemodynamic effects of intravenous paracetamol in critically ill children.
Methods: One hundred pediatric intensive care patients were followed for 120 minutes after intravenous paracetamol (PerfalganTM) administration. A hemodynamic event was defined as a drop of more than 15% in systolic or mean arterial blood pressure. Hypotension was defined as either a drop in systolic blood pressure below the 5th percentile for age or a hemodynamic event associated with tachycardia, increased lactate level, or treatment with a fluid bolus or vasopressors.
Results: A hemodynamic event was observed in 39 patients (39%) consisting of a decrease in mean systolic blood pressure from the 95th percentile before paracetamol administration to the 59th percentile after (p <0.001). Mean heart rate in this subgroup was 137bpm before treatment and 115bpm after (p=0.002). Hypotension following paracetamol administration was observed in only one patient (1%). Shock, diagnosed on admission in 15 patients, was not associated with a change in the vasoactive-inotropic score after paracetamol administration.
Conclusions: In the present study, intravenous paracetamol administration was found to be safe in critically ill pediatric patients.
