An Xin, Ma Xiaochun
Department of Critical Care Medicine, the First Hospital of China Medical University, Shenyang 110001, Liaoning, China. Corresponding author: Ma Xiaochun, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 May;35(5):453-457. doi: 10.3760/cma.j.cn121430-20221227-01119.
In 2021, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) jointly released the Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2020 with 93 recommendations. In the same year, the Japanese Society of Intensive Care Medicine (JSICM) and the Japanese Association for Acute Medicine (JAAM) also cooperated to publish the Japanese clinical practice guidelines for management of sepsis and septic shock 2020, covering 118 clinical issues in 22 areas. In this paper, 50 items in the contents of the two guidelines are compared in accordance with the order of international guidelines, including screening, initial resuscitation, mean arterial pressure, transfer to intensive care unit (ICU), diagnosis of infection, timing of antimicrobial administration, biomarkers for initiation of antimicrobial therapy, selection of antibiotic, antifungal therapy, antiviral therapy, infusion of antibiotic, pharmacokinetics and pharmacodynamics, source of infection control, antimicrobial de-escalation strategy, course of antimicrobial administration, biomarkers for discontinuation of antibiotic, fluid management, vasoactive agents, positive inotropic agents, monitoring and intravenous access, fluid balance, oxygenation targets, high-flow nasal cannula oxygen therapy, noninvasive ventilation, protective ventilation in acute respiratory distress syndrome (ARDS), low tidal volume in respiratory failure patients with non-ARDS, lung recruitment maneuvers, prone position ventilation, muscle relaxants, extracorporeal membrane oxygenation (ECMO), glucocorticoids, blood purification, red blood cell (RBC) transfusion, immunoglobulin, stress ulcer prevention, prevention of venous thromboembolism (VTE), renal replacement therapy, glycemic management, vitamin C, sodium bicarbonate therapy, nutrition, treatment goals, palliative care, peer support groups, transition of care, screening economic and social support, education for the knowledge about sepsis to the patients and their families, common decision-making, discharge planning, cognitive therapy and follow-up after discharge. It is convenient for everyone to understand some views in the field of sepsis and septic shock, and deepen their understanding.
2021年，危重病医学会（SCCM）和欧洲重症监护医学学会（ESICM）联合发布了《拯救脓毒症运动：2020年脓毒症和脓毒性休克管理国际指南》，包含93条建议。同年，日本重症监护医学学会（JSICM）和日本急性医学协会（JAAM）也合作发布了《2020年日本脓毒症和脓毒性休克管理临床实践指南》，涵盖22个领域的118个临床问题。本文按照国际指南的顺序对两份指南内容中的50项进行了比较，包括筛查、初始复苏、平均动脉压、转入重症监护病房（ICU）、感染诊断、抗菌药物给药时机、启动抗菌治疗的生物标志物、抗生素选择、抗真菌治疗、抗病毒治疗、抗生素输注、药代动力学和药效学、感染源控制、抗菌药物降阶梯策略、抗菌药物给药疗程、停用抗生素的生物标志物、液体管理、血管活性药物、正性肌力药物、监测与静脉通路、液体平衡、氧合目标、高流量鼻导管给氧治疗、无创通气、急性呼吸窘迫综合征（ARDS）中的保护性通气、非ARDS呼吸衰竭患者的低潮气量通气、肺复张手法、俯卧位通气、肌肉松弛剂、体外膜肺氧合（ECMO）、糖皮质激素、血液净化、红细胞（RBC）输注免疫球蛋白、应激性溃疡预防、静脉血栓栓塞症（VTE）预防、肾脏替代治疗、血糖管理、维生素C、碳酸氢钠治疗、营养、治疗目标、姑息治疗、同伴支持小组、护理过渡、筛查经济和社会支持、向患者及其家属进行脓毒症知识教育、共同决策、出院计划、认知治疗及出院后随访。方便大家了解脓毒症和脓毒性休克领域的一些观点，加深认识。
