ID | 66497 |
フルテキストURL | |
著者 |
Yumoto, Tetsuya
Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University
ORCID
Kaken ID
publons
Kuribara, Tomoki
School of Nursing, Sapporo City University
Yamada, Kohei
Department of Traumatology and Critical Care Medicine, National Defense Medical College Hospital
Sato, Takehito
Department of Anesthesiology, Nagoya University Hospital
Koba, Shigeru
Department of Critical Care Medicine, Nerima Hikarigaoka Hospital
Tetsuhara, Kenichi
Department of Critical Care Medicine, Fukuoka Children's Hospital
Kashiura, Masahiro
Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University
Sakuraya, Masaaki
Department of Emergency and Intensive Care Medicine, JA Hiroshima General Hospital
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抄録 | Aim: To identify the most useful tissue perfusion parameter for initial resuscitation in sepsis/septic shock adults using a network meta-analysis.
Methods: We searched major databases until December 2022 for randomized trials comparing four tissue perfusion parameters or against usual care. The primary outcome was short-term mortality up to 90 days. The Confidence in Network Meta-Analysis web application was used to assess the quality of evidence. Results: Seventeen trials were identified. Lactate-guided therapy (risk ratios, 0.59; 95% confidence intervals [0.45–0.76]; high certainty) and capillary refill time-guided therapy (risk ratios, 0.53; 95% confidence intervals [0.33–0.86]; high certainty) were significantly associated with lower short-term mortality compared with usual care, whereas central venous oxygen saturation-guided therapy (risk ratio, 1.50; 95% confidence intervals [1.16–1.94]; moderate certainty) increased the risk of short-term mortality compared with lactate-guided therapy. Conclusions: Lactate or capillary refill time-guided initial resuscitation for sepsis/septic shock patients may decrease short-term mortality. More research is essential to personalize and optimize treatment strategies for septic shock resuscitation. |
キーワード | capillary refill timecarbon dioxide gapcentral venous oxygen saturationlactatenetwork meta-analysissepsisseptic shock
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発行日 | 2023-12-26
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出版物タイトル |
Acute Medicine and Surgery
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巻 | 10巻
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号 | 1号
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出版者 | Wiley
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開始ページ | e914
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ISSN | 2052-8817
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2023 The Authors.
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1002/ams2.914
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ライセンス | https://creativecommons.org/licenses/by-nc/4.0/
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Citation | Yumoto T, Kuribara T, Yamada K, Sato T, Koba S, Tetsuhara K, et al. Clinical parameter-guided initial resuscitation in adult patients with septic shock: A systematic review and network meta-analysis. Acute Med Surg. 2023; 10:e914. https://doi.org/10.1002/ams2.914
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