Paracetamol Lowers Cerebral Temperature in Febrile Brain‑Injured Patients — NEUROTHERM RCT Shows a Modest, Clinically Relevant Effect

MedXY Editorial Team•Dec 10, 2025•Critical Care

NEUROTHERM was a double‑blind, randomized, placebo‑controlled pharmacodynamic trial testing a single IV paracetamol dose in febrile brain‑injured patients monitored with intracerebral temperature probes.
Paracetamol reduced mean cerebral temperature (CT) by 0.6°C over 6 hours versus placebo; responders (≈70%) achieved ≈1°C reduction and spent a median 215 minutes with CT <38.5°C.
Cerebral temperature exceeded systemic temperature by ≈0.3°C in both groups, indicating potentially underestimated brain heat if only systemic measurements are used.
A single IV dose was well tolerated but produced modest decreases in systolic blood pressure and heart rate; one‑third of patients did not respond to paracetamol.

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NEUROTHERM was a double‑blind, randomized, placebo‑controlled pharmacodynamic trial testing a single IV paracetamol dose in febrile brain‑injured patients monitored with intracerebral temperature probes.
Paracetamol reduced mean cerebral temperature (CT) by 0.6°C over 6 hours versus placebo; responders (≈70%) achieved ≈1°C reduction and spent a median 215 minutes with CT <38.5°C.
Cerebral temperature exceeded systemic temperature by ≈0.3°C in both groups, indicating potentially underestimated brain heat if only systemic measurements are used.
A single IV dose was well tolerated but produced modest decreases in systolic blood pressure and heart rate; one‑third of patients did not respond to paracetamol.