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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).

ABSTRACT: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE 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, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

SUBMITTER: Egi M

PROVIDER: S-EPMC8390911 | biostudies-literature | 2021 Jan-Dec

REPOSITORIES: biostudies-literature

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).

Egi Moritoki M Ogura Hiroshi H Yatabe Tomoaki T Atagi Kazuaki K Inoue Shigeaki S Iba Toshiaki T Kakihana Yasuyuki Y Kawasaki Tatsuya T Kushimoto Shigeki S Kuroda Yasuhiro Y Kotani Joji J Shime Nobuaki N Taniguchi Takumi T Tsuruta Ryosuke R Doi Kent K Doi Matsuyuki M Nakada Taka-Aki TA Nakane Masaki M Fujishima Seitaro S Hosokawa Naoto N Masuda Yoshiki Y Matsushima Asako A Matsuda Naoyuki N Yamakawa Kazuma K Hara Yoshitaka Y Sakuraya Masaaki M Ohshimo Shinichiro S Aoki Yoshitaka Y Inada Mai M Umemura Yutaka Y Kawai Yusuke Y Kondo Yutaka Y Saito Hiroki H Taito Shunsuke S Takeda Chikashi C Terayama Takero T Tohira Hideo H Hashimoto Hideki H Hayashida Kei K Hifumi Toru T Hirose Tomoya T Fukuda Tatsuma T Fujii Tomoko T Miura Shinya S Yasuda Hideto H Abe Toshikazu T Andoh Kohkichi K Iida Yuki Y Ishihara Tadashi T Ide Kentaro K Ito Kenta K Ito Yusuke Y Inata Yu Y Utsunomiya Akemi A Unoki Takeshi T Endo Koji K Ouchi Akira A Ozaki Masayuki M Ono Satoshi S Katsura Morihiro M Kawaguchi Atsushi A Kawamura Yusuke Y Kudo Daisuke D Kubo Kenji K Kurahashi Kiyoyasu K Sakuramoto Hideaki H Shimoyama Akira A Suzuki Takeshi T Sekine Shusuke S Sekino Motohiro M Takahashi Nozomi N Takahashi Sei S Takahashi Hiroshi H Tagami Takashi T Tajima Goro G Tatsumi Hiroomi H Tani Masanori M Tsuchiya Asuka A Tsutsumi Yusuke Y Naito Takaki T Nagae Masaharu M Nagasawa Ichiro I Nakamura Kensuke K Nishimura Tetsuro T Nunomiya Shin S Norisue Yasuhiro Y Hashimoto Satoru S Hasegawa Daisuke D Hatakeyama Junji J Hara Naoki N Higashibeppu Naoki N Furushima Nana N Furusono Hirotaka H Matsuishi Yujiro Y Matsuyama Tasuku T Minematsu Yusuke Y Miyashita Ryoichi R Miyatake Yuji Y Moriyasu Megumi M Yamada Toru T Yamada Hiroyuki H Yamamoto Ryo R Yoshida Takeshi T Yoshida Yuhei Y Yoshimura Jumpei J Yotsumoto Ryuichi R Yonekura Hiroshi H Wada Takeshi T Watanabe Eizo E Aoki Makoto M Asai Hideki H Abe Takakuni T Igarashi Yutaka Y Iguchi Naoya N Ishikawa Masami M Ishimaru Go G Isokawa Shutaro S Itakura Ryuta R Imahase Hisashi H Imura Haruki H Irinoda Takashi T Uehara Kenji K Ushio Noritaka N Umegaki Takeshi T Egawa Yuko Y Enomoto Yuki Y Ota Kohei K Ohchi Yoshifumi Y Ohno Takanori T Ohbe Hiroyuki H Oka Kazuyuki K Okada Nobunaga N Okada Yohei Y Okano Hiromu H Okamoto Jun J Okuda Hiroshi H Ogura Takayuki T Onodera Yu Y Oyama Yuhta Y Kainuma Motoshi M Kako Eisuke E Kashiura Masahiro M Kato Hiromi H Kanaya Akihiro A Kaneko Tadashi T Kanehata Keita K Kano Ken-Ichi KI Kawano Hiroyuki H Kikutani Kazuya K Kikuchi Hitoshi H Kido Takahiro T Kimura Sho S Koami Hiroyuki H Kobashi Daisuke D Saiki Iwao I Sakai Masahito M Sakamoto Ayaka A Sato Tetsuya T Shiga Yasuhiro Y Shimoto Manabu M Shimoyama Shinya S Shoko Tomohisa T Sugawara Yoh Y Sugita Atsunori A Suzuki Satoshi S Suzuki Yuji Y Suhara Tomohiro T Sonota Kenji K Takauji Shuhei S Takashima Kohei K Takahashi Sho S Takahashi Yoko Y Takeshita Jun J Tanaka Yuuki Y Tampo Akihito A Tsunoyama Taichiro T Tetsuhara Kenichi K Tokunaga Kentaro K Tomioka Yoshihiro Y Tomita Kentaro K Tominaga Naoki N Toyosaki Mitsunobu M Toyoda Yukitoshi Y Naito Hiromichi H Nagata Isao I Nagato Tadashi T Nakamura Yoshimi Y Nakamori Yuki Y Nahara Isao I Naraba Hiromu H Narita Chihiro C Nishioka Norihiro N Nishimura Tomoya T Nishiyama Kei K Nomura Tomohisa T Haga Taiki T Hagiwara Yoshihiro Y Hashimoto Katsuhiko K Hatachi Takeshi T Hamasaki Toshiaki T Hayashi Takuya T Hayashi Minoru M Hayamizu Atsuki A Haraguchi Go G Hirano Yohei Y Fujii Ryo R Fujita Motoki M Fujimura Naoyuki N Funakoshi Hiraku H Horiguchi Masahito M Maki Jun J Masunaga Naohisa N Matsumura Yosuke Y Mayumi Takuya T Minami Keisuke K Miyazaki Yuya Y Miyamoto Kazuyuki K Murata Teppei T Yanai Machi M Yano Takao T Yamada Kohei K Yamada Naoki N Yamamoto Tomonori T Yoshihiro Shodai S Tanaka Hiroshi H Nishida Osamu O

Acute medicine & surgery 20210101 1

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original J ...[more]

PMID: 34484801

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Project description:The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE 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, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

Project description:The 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 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] 10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.Members 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.A 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 five CQs.Based 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.

Project description:Background and Purpose:The 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. Methods:Members 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. Results:A 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. Conclusions:Based 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.

Project description:ObjectivesTo develop evidence-based recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with septic shock and other sepsis-associated organ dysfunction.DesignA panel of 49 international experts, representing 12 international organizations, as well as three methodologists and three public members was convened. Panel members assembled at key international meetings (for those panel members attending the conference), and a stand-alone meeting was held for all panel members in November 2018. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and group heads, as well as within subgroups, served as an integral part of the guideline development process.MethodsThe panel consisted of six subgroups: recognition and management of infection, hemodynamics and resuscitation, ventilation, endocrine and metabolic therapies, adjunctive therapies, and research priorities. We conducted a systematic review for each Population, Intervention, Control, and Outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak, or as a best practice statement. In addition, "in our practice" statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate.ResultsThe panel provided 77 statements on the management and resuscitation of children with septic shock and other sepsis-associated organ dysfunction. Overall, six were strong recommendations, 49 were weak recommendations, and nine were best-practice statements. For 13 questions, no recommendations could be made; but, for 10 of these, "in our practice" statements were provided. In addition, 52 research priorities were identified.ConclusionsA large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations. Despite this challenge, these recommendations regarding the management of children with septic shock and other sepsis-associated organ dysfunction provide a foundation for consistent care to improve outcomes and inform future research.

Dataset Information

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).

Publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020).

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