N Engl J Med 2015; 373:2215-2224
ICU patients with fever were randomized to acetaminophen 1g q6h or placebo. Their temperature dropped a whopping 0.3C. This didn't alter the outcomes. Earlier data for fever control appears more promising but other techniques (like surface cooling) were used. Is this an indictment of cooling- not necessarily but it shows acetaminophen doesn't do much and doesn't alter outcomes in critical illness.