Evidence map›Paper›PMID 31576434›Full record

Trial reportIntensive care medicine2019

Randomised evaluation of active control of temperature versus ordinary temperature management (REACTOR) trial.

Paul J Young, Michael J Bailey, Frances Bass, Richard W Beasley, Ross C Freebairn, Naomi E Hammond, Frank M P van Haren, Meg L Harward, Seton J Henderson, Diane M Mackle and 9 more

Open access · bronzeAbstract readClinical TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Turning up the heat on fever research?Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2021
    Article
  8. Review
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 12 institutions in 2 countries.

Paul J YoungIntensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand. paul.young@ccdhb.org.nz.ORCID 0000-0002-3428-3083
Michael J BaileyAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Frances BassCritical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Richard W BeasleyMedical Research Institute of New Zealand, Wellington, New Zealand.
Ross C FreebairnMedical Research Institute of New Zealand, Wellington, New Zealand.
Naomi E HammondCritical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Frank M P van HarenIntensive Care Unit, The Canberra Hospital, Canberra, ACT, Australia.
Meg L HarwardCritical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Seton J HendersonIntensive Care Unit, Christchurch Hospital, Christchurch, New Zealand.
Diane M MackleMedical Research Institute of New Zealand, Wellington, New Zealand.
Colin J McArthurMedical Research Institute of New Zealand, Wellington, New Zealand.
Shay P McGuinnessMedical Research Institute of New Zealand, Wellington, New Zealand.
John A MyburghCritical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Manoj K SaxenaCritical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Anne M TurnerMedical Research Institute of New Zealand, Wellington, New Zealand.
Steve A R WebbAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Rinaldo BellomoAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
REACTOR investigators
ANZICS Clinical Trials Group
Medical Research Institute of New Zealand · NZAuckland City Hospital · NZRoyal North Shore Hospital · AUUNSW Sydney · AUAustin Hospital · AUAustralian National University · AUBankstown Lidcombe Hospital · AUChristchurch Hospital · NZHawke's Bay Hospital · NZMonash University · AUThe University of Western Australia · AUWellington Hospital · NZ

Funding

Health Research Council of New Zealand 16-488
6 · The paper itself

Abstract

purposeIt is unknown whether protocols targeting systematic prevention and treatment of fever achieve lower mean body temperature than usual care in intensive care unit (ICU) patients. The objective of the Randomised Evaluation of Active Control of temperature vs. ORdinary temperature management trial was to confirm the feasibility of such a protocol with a view to conducting a larger trial.

methodsWe randomly assigned 184 adults without acute brain pathologies who had a fever in the previous 12 h, and were expected to be ventilated beyond the calendar day after recruitment, to systematic prevention and treatment of fever or usual care. The primary outcome was mean body temperature in the ICU within 7 days of randomisation. Secondary outcomes included in-hospital mortality, ICU-free days and survival time censored at hospital discharge.

resultsCompared with usual temperature management, active management significantly reduced mean temperature. In both groups, fever generally abated within 72 h. The mean temperature difference between groups was greatest in the first 48 h, when it was generally in the order of 0.5 °C. Overall, 23 of 89 patients assigned to active management (25.8%) and 23 of 89 patients assigned to usual management (25.8%) died in hospital (odds ratio 1.0, 95% CI 0.51-1.96, P = 1.0). There were no statistically significant differences between groups in ICU-free days or survival to day 90.

conclusionsActive temperature management reduced body temperature compared with usual care; however, fever abated rapidly, even in patients assigned to usual care, and the magnitude of temperature separation was small.

trial registrationAustralian and New Zealand Clinical Trials Registry Number, ACTRN12616001285448.

Indexed as

AcetaminophenAdultAgedAntipyreticsAustraliaBody TemperatureBrain DiseasesChi-Square DistributionFemaleFeverHumansIntensive Care UnitsMaleMiddle AgedNew ZealandOdds RatioAcetaminophenAntipyreticsAntipyresisCoolingFeverInfectionParacetamolSepsis

Identifiers

PMID31576434
OpenAlexW2978106586

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.