Australian Critical Care (2010) 23, 208—214 Paracetamol induced skin blood flow and blood pressure changes in febrile intensive care patients: An observational study Martin Boyle RN a,* , Lisa Nicholson RN a , Maureen O’Brien RN a , Gordon M. Flynn MRCP, FRCA, FJFICM a , David W. Collins FANZCA, FJFICM a , William R. Walsh PhD b , David Bihari FRCP, FRACP, FJFICM a a Intensive Care Unit, DBL1S, Prince of Wales Hospital, Barker Street, Randwick 2031, NSW, Australia b Director, Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School, Prince of Wales Hospital, Randwick 2031, Australia Received 6 April 2010; received in revised form 8 June 2010; accepted 28 June 2010 KEYWORDS Laser Doppler flowmetry; Acetaminophen; Paracetamol; Fever; Hypotension; Intensive care Summary Objective: To determine the relationship between paracetamol administration and skin blood flow (skBF) and blood pressure (BP) in critically ill patients treated for fever. Design: Prospective, observational study. Setting: Intensive care units of university teaching hospital. Patients: 29 adults (17 males and 12 females), aged 58 ± 15 years treated with enteral or intravenous paracetamol for fever. APACHE II score was 17.2 ± 8.3 and admission classifications were 41% medical (n = 12), 31% surgical (n = 9), and 28% neurological intervention (n = 8). Thirty healthy afebrile volunteers were also studied after ingesting 1 g paracetamol. Measurements and main results: Temperature, BP and skBF (laser Doppler flowme- try perfusion units) were recorded 15 min prior to administration of paracetamol, at administration (T0) and then for every 15 min for 60 min. Cutaneous vascular conductance (CVC = skBF/mean arterial pressure) was calculated. Thirty data sets were recorded from 29 patients. Temperature at T0 was 38.7 ± 0.6 ◦ C. BP decreased ∗ Corresponding author. E-mail address: martin.boyle@sesiahs.health.nsw.gov.au (M. Boyle). 1036-7314/ $ — see front matter © 2010 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved. doi:10.1016/j.aucc.2010.06.004