The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Abstract

Background and PurposeThe 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 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers 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.ResultsA 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 5 CQs.ConclusionsBased 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.

Coronavirus disease 2019 (COVID-19): a clinical update

“…In view of no relevant experience for reference, anticoagulation should be given with great caution in patients with DIC though microthrombosis was observed in lung, liver, and other organs by autopsy. When patients exhibit a bleeding tendency or when surgical treatment is needed, platelet transfusion or administration of fresh-frozen plasma is recommended to correct coagulopathies analogs [43].…”

Nationwide observational study of mortality from complicated intra-abdominal infections and the role of bacterial cultures

“…However, for low‐risk patients with community‐acquired CIAI, one guideline recommends not taking intra‐abdominal cultures and others have equivocal or no recommendations. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 state that various specimens, including blood, may be collected for culture from patients with sepsis or septic shock as considered necessary. Thus, there are no clear recommendations based on the severity of the patient's condition or site of onset of infection in the Japanese guidelines.…”

Pulmonary edema caused by inhalation of vapors from water‐soluble paint

“…None of the patients had a positive result from the quick Sequential Organ Failure Assessment score. 1 Fever severity was not related to inhalation time or distance from the painted background. Multiple staff members developed pulmonary edema that was caused by inhaling paint vapors.…”