論文

査読有り
2017年7月25日

The clinical practice guideline for the management of ARDS in Japan

Journal of Intensive Care
  • Satoru Hashimoto
  • ARDS clinical practice guideline committee from the Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine
  • Masamitsu Sanui
  • Moritoki Egi
  • Shinichiro Ohshimo
  • Junji Shiotsuka
  • Ryutaro Seo
  • Ryoma Tanaka
  • Yu Tanaka
  • Yasuhiro Norisue
  • Yoshiro Hayashi
  • Eishu Nango
  • Hideto Yasuda
  • Yoshitaka Aoki
  • Kohkichi Andoh
  • Yusuke Iizuka
  • Hitoshi Imaizumi
  • Satoshi Okamori
  • Motoshi Kainuma
  • Jun Kataoka
  • Tetsuro Kamo
  • Atsushi Kawaguchi
  • Junji Kumasawa
  • Kiyoyasu Kurahashi
  • Kunihiko Kooguchi
  • Yutaka Kondo
  • Masaaki Sakuraya
  • Akira Shimoyama
  • So Suzuki
  • Hiroyuki Suzuki
  • Motohiro Sekino
  • Mikio Nakajima
  • Tetsuro Nishimura
  • Tatsuma Fukuda
  • Jun Makino
  • Ryoichi Miyashita
  • Ryutaro Moriwaki
  • Shigenori Yoshitake
  • Yumi Yamashita
  • Yoshiko Nakagawa
  • Takaaki Suzuki
  • Toshiyuki Aokage
  • Kimitaka Tajimi
  • Hidemichi Yuasa
  • Hideaki Imanaka
  • Kazuya Ichikado
  • Ayumu Nozaki
  • Ryo Kozu
  • Takeshi Unoki
  • Yoshinori Takahashi
  • Akimichi Serita
  • Eriko Takezawa
  • Toshio Fukuoka
  • Taku Yabuki
  • Morio Aihara
  • Takeo Nakayama
  • 全て表示

5
1
開始ページ
50
終了ページ
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s40560-017-0222-3
出版者・発行元
BioMed Central Ltd.

Background: The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. Method: The guideline was developed applying the GRADE system for performing robust systematic reviews with plausible recommendations. The guideline consists of 13 clinical questions mainly regarding ventilator settings and drug therapies (the last question includes 11 medications that are not approved for clinical use in Japan). Results: The recommendations for adult patients with ARDS include: we suggest against early tracheostomy (GRADE 2C), we suggest using NPPV for early respiratory management (GRADE 2C), we recommend the use of low tidal volumes at 6-8 mL/kg (GRADE 1B), we suggest setting the plateau pressure at 30cmH20 or less (GRADE2B), we suggest using PEEP within the range of plateau pressures less than or equal to 30cmH2O, without compromising hemodynamics (Grade 2B), and using higher PEEP levels in patients with moderate to severe ARDS (Grade 2B), we suggest using protocolized methods for liberation from mechanical ventilation (Grade 2D), we suggest prone positioning especially in patients with moderate to severe respiratory dysfunction (GRADE 2C), we suggest against the use of high frequency oscillation (GRADE 2C), we suggest the use of neuromuscular blocking agents in patients requiring mechanical ventilation under certain circumstances (GRADE 2B), we suggest fluid restriction in the management of ARDS (GRADE 2A), we do not suggest the use of neutrophil elastase inhibitors (GRADE 2D), we suggest the administration of steroids, equivalent to methylprednisolone 1-2mg/kg/ day (GRADE 2A), and we do not recommend other medications for the treatment of adult patients with ARDS (GRADE1B
inhaled/intravenous β2 stimulants, prostaglandin E1, activated protein C, ketoconazole, and lisofylline, GRADE 1C
inhaled nitric oxide, GRADE 1D
surfactant, GRADE 2B
granulocyte macrophage colony-stimulating factor, N-acetylcysteine, GRADE 2C
Statin.) Conclusions: This article was translated from the Japanese version originally published as the ARDS clinical practice guidelines 2016 by the committee of ARDS clinical practice guideline (Tokyo, 2016, 293p, available from http://www.jsicm.org/ARDSGL/ARDSGL2016.pdf ). The original article, written for Japanese healthcare providers, provides points of view that are different from those in other countries.

リンク情報
DOI
https://doi.org/10.1186/s40560-017-0222-3
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28770093
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85026245567&origin=inward 本文へのリンクあり
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85026245567&origin=inward
ID情報
  • DOI : 10.1186/s40560-017-0222-3
  • ISSN : 2052-0492
  • eISSN : 2052-0492
  • PubMed ID : 28770093
  • SCOPUS ID : 85026245567

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