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《2016年日本脓毒症及脓毒性休克管理临床实践指南》(J-SSCG 2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016).

作者信息

Nishida Osamu, Ogura Hiroshi, Egi Moritoki, Fujishima Seitaro, Hayashi Yoshiro, Iba Toshiaki, Imaizumi Hitoshi, Inoue Shigeaki, Kakihana Yasuyuki, Kotani Joji, Kushimoto Shigeki, Masuda Yoshiki, Matsuda Naoyuki, Matsushima Asako, Nakada Taka-Aki, Nakagawa Satoshi, Nunomiya Shin, Sadahiro Tomohito, Shime Nobuaki, Yatabe Tomoaki, Hara Yoshitaka, Hayashida Kei, Kondo Yutaka, Sumi Yuka, Yasuda Hideto, Aoyama Kazuyoshi, Azuhata Takeo, Doi Kent, Doi Matsuyuki, Fujimura Naoyuki, Fuke Ryota, Fukuda Tatsuma, Goto Koji, Hasegawa Ryuichi, Hashimoto Satoru, Hatakeyama Junji, Hayakawa Mineji, Hifumi Toru, Higashibeppu Naoki, Hirai Katsuki, Hirose Tomoya, Ide Kentaro, Kaizuka Yasuo, Kan'o Tomomichi, Kawasaki Tatsuya, Kuroda Hiromitsu, Matsuda Akihisa, Matsumoto Shotaro, Nagae Masaharu, Onodera Mutsuo, Ohnuma Tetsu, Oshima Kiyohiro, Saito Nobuyuki, Sakamoto So, Sakuraya Masaaki, Sasano Mikio, Sato Norio, Sawamura Atsushi, Shimizu Kentaro, Shirai Kunihiro, Takei Tetsuhiro, Takeuchi Muneyuki, Takimoto Kohei, Taniguchi Takumi, Tatsumi Hiroomi, Tsuruta Ryosuke, Yama Naoya, Yamakawa Kazuma, Yamashita Chizuru, Yamashita Kazuto, Yoshida Takeshi, Tanaka Hiroshi, Oda Shigeto

机构信息

1Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan.

2Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

出版信息

J Intensive Care. 2018 Feb 2;6:7. doi: 10.1186/s40560-017-0270-8. eCollection 2018.

Abstract

BACKGROUND AND PURPOSE

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in , [2017; Volume 24 (supplement 2)] 10.3918/jsicm.24S0001 and [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.

METHODS

Members of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.

RESULTS

A total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.

CONCLUSIONS

Based on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

摘要

背景与目的

《2016年日本脓毒症及脓毒性休克管理临床实践指南》(J-SSCG 2016)是由日本重症医学会和日本急性医学协会联合制定的一套针对日本国情的脓毒症及脓毒性休克临床实践指南,于2017年2月首次发布,并发表于[2017年;第24卷(增刊2)] 10.3918/jsicm.24S0001以及[2017年;第28卷,(增刊1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc。本J-SSCG 2016的英文节略版经日本急性医学协会和日本重症医学会许可制作。

方法

挑选日本重症医学会和日本急性医学协会的成员,组成19名委员会成员和52名工作组成员。指南按照医学信息网络分发服务(Minds)的制定程序编写。组建学术指南推广团队,以监督并为分配给每个指南制定团队的各自活动提供学术支持。为提高质量保证和工作流程透明度,建立了相互同行评审系统,每个团队内部的讨论向公众开放。在最初提出临床问题(CQ)后收集一次公众意见,在最终草案评审期间收集两次。在获得19名委员会成员中三分之二(>66.6%)多数票的支持后,确定建议被采纳。

结果

在19个临床领域共挑选出87个CQ,包括儿科主题以及日本指南第一版(J-SSCG 2012)未涵盖的其他几个重要领域。通过委员会投票获得的批准率,以及建议强度评级和支持证据也被添加到每个建议声明中。我们对29个CQ进行了荟萃分析。由于证据不足,37个CQ包含专家共识形式的建议。5个CQ未提供建议。

结论

基于收集到的证据,我们能够以高度透明的方式制定适合日本国情的日本特定临床实践指南。这些指南不仅专科医生可以轻松使用,非专科医生、普通临床医生、护士、药剂师、临床工程师和其他医疗保健专业人员也可以轻松使用。

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