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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
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
発行日
2023-12-26
出版物タイトル
Acute Medicine and Surgery
10巻
1号
出版者
Wiley
開始ページ
e914
ISSN
2052-8817
資料タイプ
学術雑誌論文
言語
英語
OAI-PMH Set
岡山大学
著作権者
© 2023 The Authors.
論文のバージョン
publisher
PubMed ID
DOI
Web of Science KeyUT
関連URL
isVersionOf https://doi.org/10.1002/ams2.914
ライセンス
https://creativecommons.org/licenses/by-nc/4.0/
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