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Shime N, Nakada T, Yatabe T, Yamakawa K, Aoki Y, Inoue S, Iba T, Ogura H, Kawai Y, Kawaguchi A, Kawasaki T, Kondo Y, Sakuraya M, Taito S, Doi K, Hashimoto H, Hara Y, Fukuda T, Matsushima A, Egi M, Kushimoto S, Oami T, Kikutani K, Kotani Y, Aikawa G, Aoki M, Akatsuka M, Asai H, Abe T, Amemiya Y, Ishizawa R, Ishihara T, Ishimaru T, Itosu Y, Inoue H, Imahase H, Imura H, Iwasaki N, Ushio N, Uchida M, Uchi M, Umegaki T, Umemura Y, Endo A, Oi M, Ouchi A, Osawa I, Oshima Y, Ota K, Ohno T, Okada Y, Okano H, Ogawa Y, Kashiura M, Kasugai D, Kano K, Kamidani R, Kawauchi A, Kawakami S, Kawakami D, Kawamura Y, Kandori K, Kishihara Y, Kimura S, Kubo K, Kuribara T, Koami H, Koba S, Sato T, Sato R, Sawada Y, Shida H, Shimada T, Shimizu M, Shimizu K, Shiraishi T, Shinkai T, Tampo A, Sugiura G, Sugimoto K, Sugimoto H, Suhara T, Sekino M, Sonota K, Taito M, Takahashi N, Takeshita J, Takeda C, Tatsuno J, Tanaka A, Tani M, Tanikawa A, Chen H, Tsuchida T, Tsutsumi Y, Tsunemitsu T, Deguchi R, Tetsuhara K, Terayama T, Togami Y, et alShime N, Nakada T, Yatabe T, Yamakawa K, Aoki Y, Inoue S, Iba T, Ogura H, Kawai Y, Kawaguchi A, Kawasaki T, Kondo Y, Sakuraya M, Taito S, Doi K, Hashimoto H, Hara Y, Fukuda T, Matsushima A, Egi M, Kushimoto S, Oami T, Kikutani K, Kotani Y, Aikawa G, Aoki M, Akatsuka M, Asai H, Abe T, Amemiya Y, Ishizawa R, Ishihara T, Ishimaru T, Itosu Y, Inoue H, Imahase H, Imura H, Iwasaki N, Ushio N, Uchida M, Uchi M, Umegaki T, Umemura Y, Endo A, Oi M, Ouchi A, Osawa I, Oshima Y, Ota K, Ohno T, Okada Y, Okano H, Ogawa Y, Kashiura M, Kasugai D, Kano K, Kamidani R, Kawauchi A, Kawakami S, Kawakami D, Kawamura Y, Kandori K, Kishihara Y, Kimura S, Kubo K, Kuribara T, Koami H, Koba S, Sato T, Sato R, Sawada Y, Shida H, Shimada T, Shimizu M, Shimizu K, Shiraishi T, Shinkai T, Tampo A, Sugiura G, Sugimoto K, Sugimoto H, Suhara T, Sekino M, Sonota K, Taito M, Takahashi N, Takeshita J, Takeda C, Tatsuno J, Tanaka A, Tani M, Tanikawa A, Chen H, Tsuchida T, Tsutsumi Y, Tsunemitsu T, Deguchi R, Tetsuhara K, Terayama T, Togami Y, Totoki T, Tomoda Y, Nakao S, Nagasawa H, Nakatani Y, Nakanishi N, Nishioka N, Nishikimi M, Noguchi S, Nonami S, Nomura O, Hashimoto K, Hatakeyama J, Hamai Y, Hikone M, Hisamune R, Hirose T, Fuke R, Fujii R, Fujie N, Fujinaga J, Fujinami Y, Fujiwara S, Funakoshi H, Homma K, Makino Y, Matsuura H, Matsuoka A, Matsuoka T, Matsumura Y, Mizuno A, Miyamoto S, Miyoshi Y, Murata S, Murata T, Yakushiji H, Yasuo S, Yamada K, Yamada H, Yamamoto R, Yamamoto R, Yumoto T, Yoshida Y, Yoshihiro S, Yoshimura S, Yoshimura J, Yonekura H, Wakabayashi Y, Wada T, Watanabe S, Ijiri A, Ugata K, Uda S, Onodera R, Takahashi M, Nakajima S, Honda J, Matsumoto T. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024. Acute Med Surg 2025; 12:e70037. [PMID: 39996161 PMCID: PMC11848044 DOI: 10.1002/ams2.70037] [Show More Authors] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Accepted: 12/19/2024] [Indexed: 02/26/2025] Open
Abstract
The 2024 revised edition of the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock (J-SSCG 2024) is published by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine. This is the fourth revision since the first edition was published in 2012. The purpose of the guidelines is to assist healthcare providers in making appropriate decisions in the treatment of sepsis and septic shock, leading to improved patient outcomes. We aimed to create guidelines that are easy to understand and use for physicians who recognize sepsis and provide initial management, specialized physicians who take over the treatment, and multidisciplinary healthcare providers, including nurses, physical therapists, clinical engineers, and pharmacists. The J-SSCG 2024 covers the following nine areas: diagnosis of sepsis and source control, antimicrobial therapy, initial resuscitation, blood purification, disseminated intravascular coagulation, adjunctive therapy, post-intensive care syndrome, patient and family care, and pediatrics. In these areas, we extracted 78 important clinical issues. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 42 GRADE-based recommendations, 7 good practice statements, and 22 information-to-background questions were created as responses to clinical questions. We also described 12 future research questions.
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Affiliation(s)
- Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Taka‐aki Nakada
- Department of Emergency and Critical Care MedicineChiba University Graduate School of MedicineChibaJapan
| | - Tomoaki Yatabe
- Emergency DepartmentNishichita General HospitalTokaiJapan
| | - Kazuma Yamakawa
- Department of Emergency and Critical Care MedicineOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Yoshitaka Aoki
- Department of Anesthesiology and Intensive Care MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Shigeaki Inoue
- Department of Emergency and Critical Care MedicineWakayama Medical UniversityWakayamaJapan
| | - Toshiaki Iba
- Department of Emergency and Disaster MedicineJuntendo UniversityTokyoJapan
| | - Hiroshi Ogura
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Yusuke Kawai
- Department of NursingFujita Health University HospitalToyoakeJapan
| | - Atsushi Kawaguchi
- Division of Pediatric Critical Care, Department of Pediatrics, School of MedicineSt. Marianna UniversityKawasakiJapan
| | - Tatsuya Kawasaki
- Department of Pediatric Critical CareShizuoka Children's HospitalShizuokaJapan
| | - Yutaka Kondo
- Department of Emergency and Critical Care MedicineJuntendo University, Urayasu HospitalUrayasuJapan
| | - Masaaki Sakuraya
- Department of Emergency and Intensive Care MedicineJA Hiroshima General HospitalHatsukaichiJapan
| | - Shunsuke Taito
- Division of Rehabilitation, Department of Clinical Practice and SupportHiroshima University HospitalHiroshimaJapan
| | - Kent Doi
- Department of Emergency and Critical Care MedicineThe University of TokyoTokyoJapan
| | - Hideki Hashimoto
- Department of Infectious Diseases, Hitachi Medical Education and Research CenterUniversity of Tsukuba HospitalHitachiJapan
| | - Yoshitaka Hara
- Department of Anesthesiology and Critical Care MedicineFujita Health University School of MedicineToyoakeJapan
| | - Tatsuma Fukuda
- Department of Emergency and Critical Care MedicineToranomon HospitalTokyoJapan
| | - Asako Matsushima
- Department of Emergency and Critical CareNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Moritoki Egi
- Department of Anesthesia and Intensive CareKyoto University HospitalKyotoJapan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Takehiko Oami
- Department of Emergency and Critical Care MedicineChiba University Graduate School of MedicineChibaJapan
| | - Kazuya Kikutani
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Yuki Kotani
- Department of Intensive Care MedicineKameda Medical CenterKamogawaJapan
| | - Gen Aikawa
- Department of Adult Health Nursing, College of NursingIbaraki Christian UniversityHitachiJapan
| | - Makoto Aoki
- Division of TraumatologyNational Defense Medical College Research InstituteTokorozawaJapan
| | - Masayuki Akatsuka
- Department of Intensive Care MedicineSapporo Medical University School of MedicineSapporoJapan
| | - Hideki Asai
- Department of Emergency and Critical Care MedicineNara Medical UniversityNaraJapan
| | - Toshikazu Abe
- Department of Emergency and Critical Care MedicineTsukuba Memorial HospitalTsukubaJapan
| | - Yu Amemiya
- Department of Emergency and Critical Care MedicineOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Ryo Ishizawa
- Department of Critical Care and Emergency MedicineTokyo Metropolitan Tama Medical CenterTokyoJapan
| | - Tadashi Ishihara
- Department of Emergency and Critical Care MedicineJuntendo University, Urayasu HospitalUrayasuJapan
| | - Tadayoshi Ishimaru
- Department of Emergency MedicineChiba Kaihin Municipal HospitalChibaJapan
| | - Yusuke Itosu
- Department of AnesthesiologyHokkaido University HospitalSapporoJapan
| | - Hiroyasu Inoue
- Division of Physical Therapy, Department of RehabilitationShowa University School of Nursing and Rehabilitation SciencesYokohamaJapan
| | - Hisashi Imahase
- Division of Intensive Care, Department of Anesthesiology and Intensive Care MedicineJichi Medical University School of MedicineShimotsukeJapan
| | - Haruki Imura
- Department of Infectious DiseasesRakuwakai Otowa HospitalKyotoJapan
| | - Naoya Iwasaki
- Department of Anesthesiology and Intensive Care MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Noritaka Ushio
- Department of Emergency and Critical Care MedicineOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Masatoshi Uchida
- Department of Emergency and Critical Care MedicineDokkyo Medical UniversityTochigiJapan
| | - Michiko Uchi
- National Hospital Organization Ibarakihigashi National HospitalNaka‐gunJapan
| | - Takeshi Umegaki
- Department of AnesthesiologyKansai Medical UniversityHirakataJapan
| | - Yutaka Umemura
- Division of Trauma and Surgical Critical CareOsaka General Medical CenterOsakaJapan
| | - Akira Endo
- Department of Acute Critical Care MedicineTsuchiura Kyodo General HospitalTsuchiuraJapan
| | - Marina Oi
- Department of Emergency and Critical Care MedicineKitasato University School of MedicineSagamiharaJapan
| | - Akira Ouchi
- Department of Adult Health Nursing, College of NursingIbaraki Christian UniversityHitachiJapan
| | - Itsuki Osawa
- Department of Emergency and Critical Care MedicineThe University of TokyoTokyoJapan
| | | | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Takanori Ohno
- Department of Emergency and Crical Care MedicineShin‐Yurigaoka General HospitalKawasakiJapan
| | - Yohei Okada
- Department of Preventive ServicesKyoto UniversityKyotoJapan
| | - Hiromu Okano
- Department of Critical Care MedicineSt. Luke's International HospitalTokyoJapan
| | - Yoshihito Ogawa
- Division of Trauma and Surgical Critical CareOsaka General Medical CenterOsakaJapan
| | - Masahiro Kashiura
- Department of Emergency and Critical Care MedicineJichi Medical University Saitama Medical CenterSaitamaJapan
| | - Daisuke Kasugai
- Department of Emergency and Critical Care MedicineNagoya University Graduate School of MedicineNagoyaJapan
| | - Ken‐ichi Kano
- Department of Emergency MedicineFukui Prefectural HospitalFukuiJapan
| | - Ryo Kamidani
- Department of Emergency and Disaster MedicineGifu University Graduate School of MedicineGifuJapan
| | - Akira Kawauchi
- Department of Critical Care and Emergency MedicineJapanese Red Cross Maebashi HospitalMaebashiJapan
| | - Sadatoshi Kawakami
- Department of AnesthesiologyCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Daisuke Kawakami
- Department of Intensive Care MedicineAso Iizuka HospitalIizukaJapan
| | - Yusuke Kawamura
- Department of RehabilitationShowa General HospitalTokyoJapan
| | - Kenji Kandori
- Department of Emergency and Critical Care Medicine, Japanese Red Cross SocietyKyoto Daini HospitalKyotoJapan
| | - Yuki Kishihara
- Department of Emergency and Critical Care MedicineJichi Medical University Saitama Medical CenterSaitamaJapan
| | - Sho Kimura
- Department of Pediatric Critical Care MedicineTokyo Women's Medical University Yachiyo Medical CenterYachiyoJapan
| | - Kenji Kubo
- Department of Emergency MedicineJapanese Red Cross Wakayama Medical CenterWakayamaJapan
- Department of Infectious DiseasesJapanese Red Cross Wakayama Medical CenterWakayamaJapan
| | - Tomoki Kuribara
- Department of Acute and Critical Care Nursing, School of NursingSapporo City UniversitySapporoJapan
| | - Hiroyuki Koami
- Department of Emergency and Critical Care MedicineSaga UniversitySagaJapan
| | - Shigeru Koba
- Department of Critical Care MedicineNerima Hikarigaoka HospitalNerimaJapan
| | - Takehito Sato
- Department of AnesthesiologyNagoya University HospitalNagoyaJapan
| | - Ren Sato
- Department of NursingTokyo Medical University HospitalShinjukuJapan
| | - Yusuke Sawada
- Department of Emergency MedicineGunma University Graduate School of MedicineMaebashiJapan
| | - Haruka Shida
- Data Science, Medical DivisionAstraZeneca K.KOsakaJapan
| | - Tadanaga Shimada
- Department of Emergency and Critical Care MedicineChiba University Graduate School of MedicineChibaJapan
| | - Motohiro Shimizu
- Department of Intensive Care MedicineRyokusen‐Kai Yonemori HospitalKagoshimaJapan
| | | | | | - Toru Shinkai
- The Advanced Emergency and Critical Care CenterMie University HospitalTsuJapan
| | - Akihito Tampo
- Department of Emergency MedicineAsahiakwa Medical UniversityAsahikawaJapan
| | - Gaku Sugiura
- Department of Critical Care and Emergency MedicineJapanese Red Cross Maebashi HospitalMaebashiJapan
| | - Kensuke Sugimoto
- Department of Anesthesiology and Intensive CareGunma UniversityMaebashiJapan
| | - Hiroshi Sugimoto
- Department of Internal MedicineNational Hospital Organization Kinki‐Chuo Chest Medical CenterOsakaJapan
| | - Tomohiro Suhara
- Department of AnesthesiologyKeio University School of MedicineShinjukuJapan
| | - Motohiro Sekino
- Department of Anesthesiology and Intensive Care MedicineNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Kenji Sonota
- Department of Intensive Care MedicineMiyagi Children's HospitalSendaiJapan
| | - Mahoko Taito
- Department of NursingHiroshima University HospitalHiroshimaJapan
| | - Nozomi Takahashi
- Centre for Heart Lung InnovationUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Jun Takeshita
- Department of AnesthesiologyOsaka Women's and Children's HospitalIzumiJapan
| | - Chikashi Takeda
- Department of Anesthesia and Intensive CareKyoto University HospitalKyotoJapan
| | - Junko Tatsuno
- Department of NursingKokura Memorial HospitalKitakyushuJapan
| | - Aiko Tanaka
- Department of Intensive CareUniversity of Fukui HospitalFukuiJapan
| | - Masanori Tani
- Division of Critical Care MedicineSaitama Children's Medical CenterSaitamaJapan
| | - Atsushi Tanikawa
- Division of Emergency and Critical Care MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Hao Chen
- Department of PulmonaryYokohama City University HospitalYokohamaJapan
| | - Takumi Tsuchida
- Department of AnesthesiologyHokkaido University HospitalSapporoJapan
| | - Yusuke Tsutsumi
- Department of Emergency MedicineNational Hospital Organization Mito Medical CenterIbaragiJapan
| | | | - Ryo Deguchi
- Department of Traumatology and Critical Care MedicineOsaka Metropolitan University HospitalOsakaJapan
| | - Kenichi Tetsuhara
- Department of Critical Care MedicineFukuoka Children's HospitalFukuokaJapan
| | - Takero Terayama
- Department of EmergencySelf‐Defense Forces Central HospitalTokyoJapan
| | - Yuki Togami
- Department of Acute Medicine and Critical Care Medical CenterNational Hospital Organization Osaka National HospitalOsakaJapan
| | - Takaaki Totoki
- Department of AnesthesiologyKyushu University Beppu HospitalBeppuJapan
| | - Yoshinori Tomoda
- Laboratory of Clinical Pharmacokinetics, Research and Education Center for Clinical PharmacyKitasato University School of PharmacyTokyoJapan
| | - Shunichiro Nakao
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka HospitalJuntendo UniversityShizuokaJapan
| | | | - Nobuto Nakanishi
- Department of Disaster and Emergency MedicineKobe UniversityKobeJapan
| | - Norihiro Nishioka
- Department of Emergency and Crical Care MedicineShin‐Yurigaoka General HospitalKawasakiJapan
| | - Mitsuaki Nishikimi
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Satoko Noguchi
- Department of AnesthesiologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Suguru Nonami
- Department of Emergency and Critical Care MedicineKyoto Katsura HospitalKyotoJapan
| | - Osamu Nomura
- Medical Education Development CenterGifu UniversityGifuJapan
| | - Katsuhiko Hashimoto
- Department of Emergency and Intensive Care MedicineFukushima Medical UniversityFukushimaJapan
| | - Junji Hatakeyama
- Department of Emergency and Critical Care MedicineOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Yasutaka Hamai
- Department of Preventive ServicesKyoto UniversityKyotoJapan
| | - Mayu Hikone
- Department of Emergency MedicineTokyo Metropolitan Bokutoh HospitalTokyoJapan
| | - Ryo Hisamune
- Department of Emergency and Critical Care MedicineOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Ryota Fuke
- Department of Internal MedicineIMS Meirikai Sendai General HospitalSendaiJapan
| | - Ryo Fujii
- Emergency DepartmentAgeo Central General HospitalAgeoJapan
| | - Naoki Fujie
- Department of PharmacyOsaka Psychiatric Medical CenterHirakataJapan
| | - Jun Fujinaga
- Emergency and Critical Care CenterKurashiki Central HospitalKurashikiJapan
| | - Yoshihisa Fujinami
- Department of Emergency MedicineKakogawa Central City HospitalKakogawaJapan
| | - Sho Fujiwara
- Department of Emergency MedicineTokyo Hikifune HospitalTokyoJapan
- Department of Infectious DiseasesTokyo Hikifune HospitalTokyoJapan
| | - Hiraku Funakoshi
- Department of Emergency and Critical Care MedicineTokyobay Urayasu Ichikawa Medical CenterUrayasuJapan
| | - Koichiro Homma
- Department of Emergency and Critical Care MedicineKeio University School of MedicineShinjukuJapan
| | - Yuto Makino
- Department of Preventive ServicesKyoto UniversityKyotoJapan
| | - Hiroshi Matsuura
- Osaka Prefectural Nakakawachi Emergency and Critical Care CenterHigashiosakaJapan
| | - Ayaka Matsuoka
- Department of Emergency and Critical Care MedicineSaga UniversitySagaJapan
| | - Tadashi Matsuoka
- Department of Emergency and Critical Care MedicineKeio University School of MedicineShinjukuJapan
| | - Yosuke Matsumura
- Department of Intensive CareChiba Emergency and Psychiatric Medical CenterChibaJapan
| | - Akito Mizuno
- Department of Anesthesia and Intensive CareKyoto University HospitalKyotoJapan
| | - Sohma Miyamoto
- Department of Emergency and Critical Care MedicineSt. Luke's International HospitalChuo‐kuJapan
| | - Yukari Miyoshi
- Department of Emergency and Critical Care MedicineJuntendo University, Urayasu HospitalUrayasuJapan
| | - Satoshi Murata
- Division of Emergency MedicineHyogo Prefectural Kobe Children's HospitalKobeJapan
| | - Teppei Murata
- Department of CardiologyMiyazaki Prefectural Nobeoka HospitalNobeokaJapan
| | | | | | - Kohei Yamada
- Department of Traumatology and Critical Care MedicineNational Defense Medical College HospitalSaitamaJapan
| | - Hiroyuki Yamada
- Department of Primary Care and Emergency Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Ryo Yamamoto
- Department of Emergency and Critical Care MedicineKeio University School of MedicineShinjukuJapan
| | - Ryohei Yamamoto
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE)Fukushima Medical UniversityFukushimaJapan
| | - Tetsuya Yumoto
- Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical SciencesOkayama UniversityOkayamaJapan
| | - Yuji Yoshida
- Department of Anesthesia and Intensive CareKyoto University HospitalKyotoJapan
| | - Shodai Yoshihiro
- Department of Pharmaceutical ServicesHiroshima University HospitalHiroshimaJapan
| | | | - Jumpei Yoshimura
- Department of Traumatology and Acute Critical MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Hiroshi Yonekura
- Department of Anesthesiology and Pain MedicineFujita Health University Bantane HospitalNagoyaJapan
| | - Yuki Wakabayashi
- Department of NursingKobe City Medical Center General HospitalKobeJapan
| | - Takeshi Wada
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Faculty of MedicineHokkaido UniversitySapporoJapan
| | - Shinichi Watanabe
- Department of Physical Therapy, Faculty of RehabilitationGifu University of Health ScienceGifuJapan
| | - Atsuhiro Ijiri
- Department of Traumatology and Critical Care MedicineNational Defense Medical College HospitalSaitamaJapan
| | - Kei Ugata
- Department of Intensive Care MedicineMatsue Red Cross HospitalMatsueJapan
| | - Shuji Uda
- Department of Anesthesia and Intensive CareKyoto University HospitalKyotoJapan
| | - Ryuta Onodera
- Department of Preventive ServicesKyoto UniversityKyotoJapan
| | - Masaki Takahashi
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Faculty of MedicineHokkaido UniversitySapporoJapan
| | - Satoshi Nakajima
- Department of Emergency MedicineKyoto Prefectural University of MedicineKyotoJapan
| | - Junta Honda
- Department of Emergency and Critical Care MedicineNagoya University Graduate School of MedicineNagoyaJapan
| | - Tsuguhiro Matsumoto
- Department of Anesthesia and Intensive CareKyoto University HospitalKyotoJapan
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Park C, Ku NS, Park DW, Park JH, Ha TS, Kim DW, Park SY, Chang Y, Jo KW, Baek MS, Seo Y, Shin TG, Yu G, Lee J, Choi YJ, Jang JY, Jung YT, Jeong I, Cho HJ, Woo A, Kim S, Bae DH, Kang SW, Park SH, Suh GY, Park S. Early management of adult sepsis and septic shock: Korean clinical practice guidelines. Acute Crit Care 2024; 39:445-472. [PMID: 39622601 PMCID: PMC11617831 DOI: 10.4266/acc.2024.00920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Revised: 09/06/2024] [Accepted: 09/09/2024] [Indexed: 12/08/2024] Open
Abstract
BACKGROUND Despite recent advances and global improvements in sepsis recognition and supportive care, mortality rates remain high, and adherence to sepsis bundle components in Korea is low. To address this, the Korean Sepsis Alliance, affiliated with the Korean Society of Critical Care Medicine, developed the first sepsis treatment guidelines for Korea based on a comprehensive systematic review and meta-analysis. METHODS A de novo method was used to develop the guidelines. Methodologies included determining key questions, conducting a literature search and selection, assessing the risk of bias, synthesizing evidence, and developing recommendations. The certainty of evidence and the strength of recommendations were determined using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Draft recommendations underwent internal and external review processes and public hearings. The development of these guidelines was supported by a research grant from the Korean Disease Control and Prevention Agency. RESULTS In these guidelines, we focused on early treatments for adult patients with sepsis and septic shock. Through the guideline development process, 12 key questions and their respective recommendations were formulated. These include lactate measurement, fluid therapies, target blood pressure, antibiotic administration, use of vasopressors and dobutamine, extracorporeal membrane oxygenation, and echocardiography. CONCLUSIONS These guidelines aim to support medical professionals in making appropriate decisions about treating adult sepsis and septic shock. We hope these guidelines will increase awareness of sepsis and reduce its mortality rate.
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Affiliation(s)
- Chul Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Nam Su Ku
- Division of Infective Diseases, Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Dae Won Park
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Joo Hyun Park
- Respiratory Medicine, Department of Internal Medicine, Seoul Metropolitan Seonam Hospital, Seoul, Korea
| | - Tae Sun Ha
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Do Wan Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - So Young Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Youjin Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Sanggye Paik Hospital, College of Medicine, Inje University Seoul, Korea
| | - Kwang Wook Jo
- Department of Neurosurgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Moon Seong Baek
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yijun Seo
- Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Gun Shin
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gina Yu
- Department of Emergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jongmin Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Jun Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Young Jang
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Yun Tae Jung
- Department of Surgery, Gangneung Asan Hospital, Gangneung, Korea
| | - Inseok Jeong
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Korea
| | - Hwa Jin Cho
- Department of Pediatrics, Chonnam National University Children's Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ala Woo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sua Kim
- Department of Critical Care Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Dae-Hwan Bae
- Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
- Division of Cardiology, Department of Internal Medicine, Bucheon Sejong Hospital, Bucheon, Korea
| | - Sung Wook Kang
- Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sun Hyo Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Keimyung University Dongsan Hospital, Daegu, Korea
| | - Gee Young Suh
- Department of Critical Care Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sunghoon Park
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
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