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The Hemodynamic Effect of Intravenous Paracetamol in Children: A Retrospective Chart Review

Elhanan Nahum1, Matan Friedman2, Eytan Kaplan1

  • 1Pediatric Intensive Care Unit, Schneider Children's Medical Center in Israel, 14 Kaplan Street, 4920235, Petach Tikva, Israel.

Paediatric Drugs
|June 4, 2019
PubMed

Insights

Intravenous paracetamol in critically ill children caused a drop in systolic blood pressure from high to normal levels. This study found no negative hemodynamic events, suggesting it is safe for pediatric intensive care patients.

Area of Science:

  • Pediatric critical care medicine
  • Pharmacology
  • Hemodynamics

Background:

  • Intravenous paracetamol is used for pain and fever management in children.
  • Previous studies in adults suggest a risk of hypotension after IV paracetamol.
  • The hemodynamic effects in critically ill children are not well-established.

Purpose of the Study:

  • To investigate the hemodynamic effects of intravenous paracetamol in critically ill children.
  • To determine the incidence of blood pressure drops following IV paracetamol administration in this population.

Main Methods:

  • Retrospective chart review of 100 pediatric intensive care patients (0.1-18 years).
  • Data collected on blood pressure, heart rate, and vasopressor use before and after IV paracetamol.
  • Hemodynamic event defined as >15% drop in systolic or mean arterial blood pressure within 120 minutes.

Main Results:

  • A hemodynamic event occurred in 39% of patients.
  • Systolic blood pressure decreased from the 99th percentile to the 50th percentile (p<0.001).
  • No patient experienced blood pressure below the 5th percentile; shock patients showed no increased vasopressor need.

Conclusions:

  • Intravenous paracetamol in critically ill children is associated with a decrease in systolic blood pressure from high to normal values.
  • The observed blood pressure changes are likely related to pain relief and not indicative of adverse hemodynamic events.
  • IV paracetamol appears to be hemodynamically safe in critically ill pediatric patients.
Abstract

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