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

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      Journal of Intensive Care
      BioMed Central
      Evidence-based medicine, GRADE, Guidelines, Sepsis, Septic shock, Systematic review

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          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.

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          Most cited references1,023

          • Record: found
          • Abstract: found
          • Article: found

          The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

          Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.
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            Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study

            Summary Background Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. It is considered a major cause of health loss, but data for the global burden of sepsis are limited. As a syndrome caused by underlying infection, sepsis is not part of standard Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimates. Accurate estimates are important to inform and monitor health policy interventions, allocation of resources, and clinical treatment initiatives. We estimated the global, regional, and national incidence of sepsis and mortality from this disorder using data from GBD 2017. Methods We used multiple cause-of-death data from 109 million individual death records to calculate mortality related to sepsis among each of the 282 underlying causes of death in GBD 2017. The percentage of sepsis-related deaths by underlying GBD cause in each location worldwide was modelled using mixed-effects linear regression. Sepsis-related mortality for each age group, sex, location, GBD cause, and year (1990–2017) was estimated by applying modelled cause-specific fractions to GBD 2017 cause-of-death estimates. We used data for 8·7 million individual hospital records to calculate in-hospital sepsis-associated case-fatality, stratified by underlying GBD cause. In-hospital sepsis-associated case-fatality was modelled for each location using linear regression, and sepsis incidence was estimated by applying modelled case-fatality to sepsis-related mortality estimates. Findings In 2017, an estimated 48·9 million (95% uncertainty interval [UI] 38·9–62·9) incident cases of sepsis were recorded worldwide and 11·0 million (10·1–12·0) sepsis-related deaths were reported, representing 19·7% (18·2–21·4) of all global deaths. Age-standardised sepsis incidence fell by 37·0% (95% UI 11·8–54·5) and mortality decreased by 52·8% (47·7–57·5) from 1990 to 2017. Sepsis incidence and mortality varied substantially across regions, with the highest burden in sub-Saharan Africa, Oceania, south Asia, east Asia, and southeast Asia. Interpretation Despite declining age-standardised incidence and mortality, sepsis remains a major cause of health loss worldwide and has an especially high health-related burden in sub-Saharan Africa. Funding The Bill & Melinda Gates Foundation, the National Institutes of Health, the University of Pittsburgh, the British Columbia Children's Hospital Foundation, the Wellcome Trust, and the Fleming Fund.
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              • Abstract: found
              • Article: not found

              Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.

              To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012".
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                Author and article information

                Contributors
                moriori@tg8.so-net.ne.jp
                ogura@hp-emerg.med.osaka-u.ac.jp
                Journal
                J Intensive Care
                J Intensive Care
                Journal of Intensive Care
                BioMed Central (London )
                2052-0492
                25 August 2021
                25 August 2021
                2021
                : 9
                : 53
                Affiliations
                [1 ]GRID grid.31432.37, ISNI 0000 0001 1092 3077, Department of Surgery Related, Division of Anesthesiology, , Kobe University Graduate School of Medicine, ; Kusunoki-cho 7-5-2, Chuo-ku, Kobe, Hyogo Japan
                [2 ]GRID grid.136593.b, ISNI 0000 0004 0373 3971, Department of Traumatology and Acute Critical Medicine, , Osaka University Medical School, ; Yamadaoka 2-15, Suita, Osaka, Japan
                [3 ]GRID grid.256115.4, ISNI 0000 0004 1761 798X, Department of Anesthesiology and Critical Care Medicine, , Fujita Health University School of Medicine, ; Toyoake, Japan
                [4 ]Department of Intensive Care Unit, Nara Prefectural General Medical Center, Nara, Japan
                [5 ]GRID grid.31432.37, ISNI 0000 0001 1092 3077, Department of Disaster and Emergency Medicine, , Kobe University Graduate School of Medicine, ; Kobe, Japan
                [6 ]GRID grid.258269.2, ISNI 0000 0004 1762 2738, Department of Emergency and Disaster Medicine, , Juntendo University, ; Tokyo, Japan
                [7 ]GRID grid.258333.c, ISNI 0000 0001 1167 1801, Department of Emergency and Intensive Care Medicine, , Kagoshima University Graduate School of Medical and Dental Sciences, ; Kagoshima, Japan
                [8 ]GRID grid.415798.6, ISNI 0000 0004 0378 1551, Department of Pediatric Critical Care, , Shizuoka Children’s Hospital, ; Shizuoka, Japan
                [9 ]GRID grid.69566.3a, ISNI 0000 0001 2248 6943, Division of Emergency and Critical Care Medicine, , Tohoku University Graduate School of Medicine, ; Sendai, Japan
                [10 ]GRID grid.258331.e, ISNI 0000 0000 8662 309X, Department of Emergency, Disaster, and Critical Care Medicine, Faculty of Medicine, , Kagawa University, ; Kagawa, Japan
                [11 ]GRID grid.31432.37, ISNI 0000 0001 1092 3077, Department of Surgery Related, Division of Disaster and Emergency Medicine, , Kobe University Graduate School of Medicine, ; Kobe, Japan
                [12 ]GRID grid.257022.0, ISNI 0000 0000 8711 3200, Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, , Hiroshima University, ; Hiroshima, Japan
                [13 ]GRID grid.9707.9, ISNI 0000 0001 2308 3329, Department of Anesthesiology and Intensive Care Medicine, , Kanazawa University, ; Kanazawa, Japan
                [14 ]GRID grid.268397.1, ISNI 0000 0001 0660 7960, Acute and General Medicine, , Yamaguchi University Graduate School of Medicine, ; Ube, Japan
                [15 ]GRID grid.26999.3d, ISNI 0000 0001 2151 536X, Department of Acute Medicine, , The University of Tokyo, ; Tokyo, Japan
                [16 ]GRID grid.505613.4, Department of Anesthesiology and Intensive Care Medicine, , Hamamatsu University School of Medicine, ; Hamamatsu, Japan
                [17 ]GRID grid.136304.3, ISNI 0000 0004 0370 1101, Department of Emergency and Critical Care Medicine, , Chiba University Graduate School of Medicine, ; Chiba, Japan
                [18 ]GRID grid.413006.0, Department of Emergency and Critical Care Medicine, , Yamagata University Hospital, ; Yamagata, Japan
                [19 ]GRID grid.26091.3c, ISNI 0000 0004 1936 9959, Center for General Medicine Education, , Keio University School of Medicine, ; Tokyo, Japan
                [20 ]GRID grid.414927.d, ISNI 0000 0004 0378 2140, Department of Infectious Diseases, , Kameda Medical Center, ; Kamogawa, Japan
                [21 ]GRID grid.263171.0, ISNI 0000 0001 0691 0855, Department of Intensive Care Medicine, , Sapporo Medical University School of Medicine, ; Sapporo, Japan
                [22 ]GRID grid.260433.0, ISNI 0000 0001 0728 1069, Department of Advancing Acute Medicine, Graduate School of Medical Sciences, , Nagoya City University, ; Nagoya, Japan
                [23 ]GRID grid.27476.30, ISNI 0000 0001 0943 978X, Department of Emergency and Critical Care Medicine, , Nagoya University Graduate School of Medicine, ; Nagoya, Japan
                [24 ]GRID grid.444883.7, ISNI 0000 0001 2109 9431, Department of Emergency Medicine, , Osaka Medical College, ; Osaka, Japan
                [25 ]GRID grid.414159.c, ISNI 0000 0004 0378 1009, Department of Emergency and Intensive Care Medicine, , JA Hiroshima General Hospital, ; Hatsukaichi, Japan
                [26 ]Member of Japanese Association for Acute Medicine, Tokyo, Japan
                [27 ]GRID grid.416985.7, ISNI 0000 0004 0378 3952, Division of Trauma and Surgical Critical Care, , Osaka General Medical Center, ; Osaka, Japan
                [28 ]GRID grid.471500.7, ISNI 0000 0004 0649 1576, Department of Nursing, , Fujita Health University Hospital, ; Toyoake, Japan
                [29 ]GRID grid.482669.7, ISNI 0000 0004 0569 1541, Department of Emergency and Critical Care Medicine, , Juntendo University Urayasu Hospital, ; Urayasu, Japan
                [30 ]GRID grid.417363.4, Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, , Yokohama City Seibu Hospital, ; Yokohama, Japan
                [31 ]GRID grid.470097.d, ISNI 0000 0004 0618 7953, Division of Rehabilitation, Department of Clinical Support and Practice, , Hiroshima University Hospital, ; Hiroshima, Japan
                [32 ]GRID grid.411217.0, ISNI 0000 0004 0531 2775, Department of Anesthesia, , Kyoto University Hospital, ; Kyoto, Japan
                [33 ]GRID grid.416614.0, ISNI 0000 0004 0374 0880, Department of Psychiatry, School of Medicine, , National Defense Medical College, ; Tokorozawa, Japan
                [34 ]GRID grid.1032.0, ISNI 0000 0004 0375 4078, Curtin University, ; Perth, Australia
                [35 ]GRID grid.414178.f, ISNI 0000 0004 1776 0989, Department of Emergency and Critical Care Medicine/Infectious Disease, , Hitachi General Hospital, ; Hitachi, Japan
                [36 ]GRID grid.250903.d, ISNI 0000 0000 9566 0634, The Feinstein Institute for Medical Research, ; Manhasset, NY USA
                [37 ]GRID grid.430395.8, Department of Emergency and Critical Care Medicine, , St. Luke’s International Hospital, ; Tokyo, Japan
                [38 ]GRID grid.416980.2, ISNI 0000 0004 1774 8373, Emergency and Critical Care Medical Center, , Osaka Police Hospital, ; Osaka, Japan
                [39 ]GRID grid.267625.2, ISNI 0000 0001 0685 5104, Department of Emergency and Critical Care Medicine, Graduate School of Medicine, , University of the Ryukyus, ; Okinawa, Japan
                [40 ]GRID grid.470100.2, ISNI 0000 0004 1756 9754, Intensive Care Unit, , Jikei University Hospital, ; Tokyo, Japan
                [41 ]GRID grid.416107.5, ISNI 0000 0004 0614 0346, The Royal Children’s Hospital Melbourne, ; Melbourne, Australia
                [42 ]GRID grid.415020.2, ISNI 0000 0004 0467 0255, Department of Emergency and Critical Care Medicine, , Jichi Medical University Saitama Medical Center, ; Saitama, Japan
                [43 ]GRID grid.410857.f, ISNI 0000 0004 0640 9106, Department of Emergency and Critical Care Medicine, , Tsukuba Memorial Hospital, ; Tsukuba, Japan
                [44 ]GRID grid.415493.e, ISNI 0000 0004 1772 3993, Division of Anesthesiology, Division of Intensive Care, Division of Emergency and Critical Care, , Sendai City Hospital, ; Sendai, Japan
                [45 ]GRID grid.443092.8, Department of Physical Therapy, School of Health Sciences, , Toyohashi Sozo University, ; Toyohashi, Japan
                [46 ]GRID grid.63906.3a, ISNI 0000 0004 0377 2305, Critical Care Medicine, , National Center for Child Health and Development, ; Tokyo, Japan
                [47 ]Department of General Pediatrics, Aichi Children’s Health and Medical Center, Obu, Japan
                [48 ]GRID grid.413697.e, ISNI 0000 0004 0378 7558, Department of Infectious Disease, , Hyogo Prefectural Amagasaki General Medical Center, ; Amagasaki, Japan
                [49 ]GRID grid.416629.e, ISNI 0000 0004 0377 2137, Department of Intensive Care Medicine, , Osaka Women’s and Children’s Hospital, ; Izumi, Japan
                [50 ]GRID grid.258799.8, ISNI 0000 0004 0372 2033, Human Health Science, Graduate School of Medicine, , Kyoto University, ; Kyoto, Japan
                [51 ]GRID grid.444711.3, ISNI 0000 0000 9028 5919, Department of Acute and Critical Care Nursing, School of Nursing, , Sapporo City University, ; Sapporo, Japan
                [52 ]GRID grid.258799.8, ISNI 0000 0004 0372 2033, Department of Pharmacoepidemiology, , Kyoto University Graduate School of Medicine and Public Health, ; Kyoto, Japan
                [53 ]GRID grid.443715.0, ISNI 0000 0000 8756 2399, College of Nursing, , Ibaraki Christian University, ; Hitachi, Japan
                [54 ]GRID grid.415442.2, ISNI 0000 0004 1763 8254, Department of Emergency and Critical Care Medicine, , Komaki City Hospital, ; Komaki, Japan
                [55 ]Gastroenterological Center, Shinkuki General Hospital, Kuki, Japan
                [56 ]GRID grid.416827.e, ISNI 0000 0000 9413 4421, Department of Surgery, , Okinawa Chubu Hospital, ; Uruma, Japan
                [57 ]GRID grid.14848.31, ISNI 0000 0001 2292 3357, CHU Sainte Justines, , University of Montreal, ; Montreal, Canada
                [58 ]GRID grid.415825.f, ISNI 0000 0004 1772 4742, Department of Rehabilitation, , Showa General Hospital, ; Tokyo, Japan
                [59 ]GRID grid.414936.d, ISNI 0000 0004 0418 6412, Department of Emergency Medicine and Department of Infectious Diseases, , Japanese Red Cross Wakayama Medical Center, ; Wakayama, Japan
                [60 ]GRID grid.411731.1, ISNI 0000 0004 0531 3030, Department of Anesthesiology and Intensive Care Medicine, , International University of Health and Welfare School of Medicine, ; Narita, Japan
                [61 ]GRID grid.265061.6, ISNI 0000 0001 1516 6626, Department of Anesthesiology, , Tokai University School of Medicine, ; Isehara, Japan
                [62 ]GRID grid.410793.8, ISNI 0000 0001 0663 3325, Department of Anesthesiology, , Tokyo Medical University, ; Tokyo, Japan
                [63 ]GRID grid.411873.8, ISNI 0000 0004 0616 1585, Division of Intensive Care, , Nagasaki University Hospital, ; Nagasaki, Japan
                [64 ]GRID grid.411582.b, ISNI 0000 0001 1017 9540, Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), , Fukushima Medical University, ; Fukushima, Japan
                [65 ]Department of Cardiology, Steel Memorial Muroran Hospital, Muroran, Japan
                [66 ]GRID grid.459842.6, ISNI 0000 0004 0406 9101, Department of Emergency and Critical Care Medicine, , Nippon Medical School Musashi Kosugi Hospital, ; Kawasaki, Japan
                [67 ]GRID grid.411873.8, ISNI 0000 0004 0616 1585, Nagasaki University Hospital Acute and Critical Care Center, ; Nagasaki, Japan
                [68 ]GRID grid.416697.b, ISNI 0000 0004 0569 8102, Division of Critical Care Medicine, , Saitama Children’s Medical Center, ; Saitama, Japan
                [69 ]GRID grid.410845.c, ISNI 0000 0004 0604 6878, Department of Emergency and Critical Care Medicine, , National Hospital Organization Mito Medical Center, ; Ibaraki, Japan
                [70 ]GRID grid.412764.2, ISNI 0000 0004 0372 3116, Department of Emergency and Critical Care Medicine, , St. Marianna University School of Medicine, ; Kawasaki, Japan
                [71 ]GRID grid.411102.7, ISNI 0000 0004 0596 6533, Department of Intensive Care Medicine, , Kobe University Hospital, ; Kobe, Japan
                [72 ]GRID grid.265061.6, ISNI 0000 0001 1516 6626, School of Medicine, , Tokai University, ; Isehara, Japan
                [73 ]GRID grid.414178.f, ISNI 0000 0004 1776 0989, Department of Emergency and Critical Care Medicine, , Hitachi General Hospital, ; Hitachi, Japan
                [74 ]GRID grid.261445.0, ISNI 0000 0001 1009 6411, Department of Traumatology and Critical Care Medicine, , Osaka City University Graduate School of Medicine, ; Osaka, Japan
                [75 ]GRID grid.410804.9, ISNI 0000000123090000, Department of Anesthesiology and Intensive Care Medicine, Division of Intensive Care, , Jichi Medical University School of Medicine, ; Shimotsuke, Japan
                [76 ]Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
                [77 ]GRID grid.272458.e, ISNI 0000 0001 0667 4960, Department of Anesthesiology and Intensive Care Medicine, , Kyoto Prefectural University of Medicine, ; Kyoto, Japan
                [78 ]GRID grid.416239.b, Department of Emergency and Critical Care Medicine, , National Hospital Organization Tokyo Medical Center, ; Tokyo, Japan
                [79 ]GRID grid.410819.5, Department of Pharmacy, , Yokohama Rosai Hospital, ; Yokohama, Japan
                [80 ]GRID grid.410843.a, ISNI 0000 0004 0466 8016, Department of Anesthesiology and Nutrition Support Team, Kobe City Medical Center General Hospital, , Kobe City Hospital Organization, ; Kobe, Japan
                [81 ]GRID grid.411102.7, ISNI 0000 0004 0596 6533, Department of Anesthesiology, , Kobe University Hospital, ; Kobe, Japan
                [82 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Department of Rehabilitation, , University of Tsukuba Hospital/Exult Co., Ltd., ; Tsukuba, Japan
                [83 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Doctoral program in Clinical Sciences. Graduate School of Comprehensive Human Sciences, , University of Tsukuba, ; Tsukuba, Japan
                [84 ]GRID grid.272458.e, ISNI 0000 0001 0667 4960, Department of Emergency Medicine, , Kyoto Prefectural University of Medicine, ; Kyoto, Japan
                [85 ]GRID grid.412398.5, ISNI 0000 0004 0403 4283, Department of Clinical Engineering, , Osaka University Hospital, ; Suita, Japan
                [86 ]GRID grid.410714.7, ISNI 0000 0000 8864 3422, Department of Intensive Care Medicine, , Showa University School of Medicine, ; Tokyo, Japan
                [87 ]Department of Clinical Engineering, Kakogawa Central City Hospital, Kakogawa, Japan
                [88 ]GRID grid.508505.d, ISNI 0000 0000 9274 2490, Division of Respiratory Care and Rapid Response System, Intensive Care Center, , Kitasato University Hospital, ; Sagamihara, Japan
                [89 ]GRID grid.452874.8, ISNI 0000 0004 1771 2506, Department of Nursing, , Toho University Omori Medical Center, ; Tokyo, Japan
                [90 ]GRID grid.411217.0, ISNI 0000 0004 0531 2775, Department of Primary Care and Emergency Medicine, , Kyoto University Hospital, ; Kyoto, Japan
                [91 ]GRID grid.26091.3c, ISNI 0000 0004 1936 9959, Department of Emergency and Critical Care Medicine, , Keio University School of Medicine, ; Tokyo, Japan
                [92 ]GRID grid.136593.b, ISNI 0000 0004 0373 3971, Department of Anesthesiology and Intensive Care Medicine, , Osaka University Graduate School of Medicine, ; Suita, Japan
                [93 ]GRID grid.416985.7, ISNI 0000 0004 0378 3952, Nursing Department, , Osaka General Medical Center, ; Osaka, Japan
                [94 ]GRID grid.452874.8, ISNI 0000 0004 1771 2506, Toho University Omori Medical Center, ; Tokyo, Japan
                [95 ]GRID grid.412075.5, ISNI 0000 0004 1769 2015, Department of Clinical Anesthesiology, , Mie University Hospital, ; Tsu, Japan
                [96 ]GRID grid.39158.36, ISNI 0000 0001 2173 7691, Department of Anesthesiology and Critical Care Medicine, Division of Acute and Critical Care Medicine, , Hokkaido University Faculty of Medicine, ; Sapporo, Japan
                [97 ]Department of Emergency and Critical Care Medicine, Eastern Chiba Medical Center, Togane, Japan
                [98 ]GRID grid.256642.1, ISNI 0000 0000 9269 4097, Department of Emergency Medicine, , Gunma University Graduate School of Medicine, ; Maebashi, Japan
                [99 ]GRID grid.410814.8, ISNI 0000 0004 0372 782X, Department of Emergency and Critical Care Medicine, , Nara Medical University, ; Kashihara, Japan
                [100 ]GRID grid.412337.0, ISNI 0000 0004 0639 8726, Department of Anesthesiology and Intensive Care, , Oita University Hospital, ; Yufu, Japan
                [101 ]GRID grid.416279.f, ISNI 0000 0004 0616 2203, Department of Emergency and Critical Care Medicine, , Nippon Medical School Hospital, ; Tokyo, Japan
                [102 ]GRID grid.136593.b, ISNI 0000 0004 0373 3971, Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, , Osaka University, ; Suita, Japan
                [103 ]GRID grid.415574.6, Department of Anesthesiology, Emergency and Critical Care Medicine, , Kure Kyosai Hospital, ; Kure, Japan
                [104 ]GRID grid.416106.4, Department of General Internal Medicine, , Soka Municipal Hospital, ; Soka, Japan
                [105 ]GRID grid.417084.e, ISNI 0000 0004 1764 9914, Department of Emergency and Critical Care Medicine, , Tokyo Metropolitan Children’s Medical Center, ; Tokyo, Japan
                [106 ]GRID grid.26999.3d, ISNI 0000 0001 2151 536X, Department of Biomedical Ethics, Graduate School of Medicine, , The University of Tokyo, ; Tokyo, Japan
                [107 ]GRID grid.415639.c, ISNI 0000 0004 0377 6680, Department of Infectious Diseases, , Rakuwakai Otowa Hospital, ; Kyoto, Japan
                [108 ]GRID grid.258799.8, ISNI 0000 0004 0372 2033, Department of Health Informatics, School of Public Health, , Kyoto University, ; Kyoto, Japan
                [109 ]GRID grid.412757.2, ISNI 0000 0004 0641 778X, Tohoku University Hospital Emergency Center, ; Sendai, Japan
                [110 ]GRID grid.414860.f, Department of Anesthesiology, National Hospital Organization Iwakuni Clinical Center, ; Iwakuni, Japan
                [111 ]Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan
                [112 ]GRID grid.410783.9, ISNI 0000 0001 2172 5041, Department of Anesthesiology, , Kansai Medical University, ; Hirakata, Japan
                [113 ]GRID grid.416704.0, ISNI 0000 0000 8733 7415, Advanced Emergency and Critical Care Center, , Saitama Red Cross Hospital, ; Saitama, Japan
                [114 ]GRID grid.20515.33, ISNI 0000 0001 2369 4728, Department of Emergency and Critical Care Medicine, , University of Tsukuba, ; Tsukuba, Japan
                [115 ]GRID grid.412808.7, ISNI 0000 0004 1764 9041, Department of Emergency and Critical Medicine, , Showa University Fujigaoka Hospital, ; Yokohama, Japan
                [116 ]GRID grid.26999.3d, ISNI 0000 0001 2151 536X, Department of Clinical Epidemiology and Health Economics, School of Public Health, , The University of Tokyo, ; Tokyo, Japan
                [117 ]Shimane Advanced Trauma Center, Izumo, Japan
                [118 ]GRID grid.258799.8, ISNI 0000 0004 0372 2033, Department of Primary care and Emergency medicine, , Kyoto University Graduate School of Medicine, ; Kyoto, Japan
                [119 ]GRID grid.411205.3, ISNI 0000 0000 9340 2869, Department of Anesthesiology, , Kyorin University School of Medicine, ; Tokyo, Japan
                [120 ]GRID grid.440410.5, ISNI 0000 0004 0569 2923, Department of ER, , Hashimoto Municipal Hospital, ; Hashimoto, Japan
                [121 ]GRID grid.69566.3a, ISNI 0000 0001 2248 6943, Department of Community Medical Supports, Tohoku Medical Megabank Organization, , Tohoku University, ; Sendai, Japan
                [122 ]GRID grid.416684.9, ISNI 0000 0004 0378 7419, Tochigi prefectural Emergency and Critical Care Center, Imperial Gift Foundation Saiseikai, , Utsunomiya Hospital, ; Utsunomiya, Japan
                [123 ]GRID grid.268394.2, ISNI 0000 0001 0674 7277, Department of Anesthesiology, Faculty of Medicine, , Yamagata University, ; Yamagata, Japan
                [124 ]GRID grid.413946.d, Department of Internal Medicine, Dialysis Center, , Kichijoji Asahi Hospital, ; Tokyo, Japan
                [125 ]Anesthesiology, Emergency Medicine, and Intensive Care Division, Inazawa Municipal Hospital, Inazawa, Japan
                [126 ]GRID grid.260433.0, ISNI 0000 0001 0728 1069, Department of Anesthesiology and Intensive Care Medicine, , Nagoya-City University Graduate School of Medical Sciences, ; Nagoya, Japan
                [127 ]GRID grid.415495.8, Department of Anesthesiology, , Sendai Medical Center, ; Sendai, Japan
                [128 ]GRID grid.412075.5, ISNI 0000 0004 1769 2015, Emergency and Critical Care Center, , Mie University Hospital, ; Tsu, Japan
                [129 ]GRID grid.415124.7, ISNI 0000 0001 0115 304X, Department of Emergency Medicine, , Fukui Prefectural Hospital, ; Fukui, Japan
                [130 ]Department of Gastroenterological Surgery, Onga Hospital, Fukuoka, Japan
                [131 ]GRID grid.415469.b, ISNI 0000 0004 1764 8727, Department of Emergency and Critical Care Medicine, , Seirei Mikatahara General Hospital, ; Hamamatsu, Japan
                [132 ]GRID grid.412814.a, ISNI 0000 0004 0619 0044, Department of Pediatrics, , University of Tsukuba Hospital, ; Tsukuba, Japan
                [133 ]GRID grid.267308.8, ISNI 0000 0000 9206 2401, Center for Translational Injury Research, , University of Texas Health Science Center at Houston, ; Houston, USA
                [134 ]GRID grid.410793.8, ISNI 0000 0001 0663 3325, Department of Anesthesiology, , Tokyo Medical University, ; Tokyo, Japan
                [135 ]Department of General Medicine Shintakeo Hospital, Takeo, Japan
                [136 ]GRID grid.412814.a, ISNI 0000 0004 0619 0044, Department of Emergency and Critical Care Medicine, , University of Tsukuba Hospital, ; Tsukuba, Japan
                [137 ]GRID grid.136304.3, ISNI 0000 0004 0370 1101, Department of Orthopaedic Surgery, Center for Advanced Joint Function and Reconstructive Spine Surgery, Graduate school of Medicine, , Chiba University, ; Chiba, Japan
                [138 ]GRID grid.410822.d, ISNI 0000 0004 0595 1091, Department of Pediatric Cardiology and Intensive Care, , Gunma Children’s Medical Center, ; Shibukawa, Japan
                [139 ]GRID grid.413376.4, ISNI 0000 0004 1761 1035, Department of Emergency and Critical Care Medicine, , Tokyo Women’s Medical University Medical Center East, ; Tokyo, Japan
                [140 ]GRID grid.268441.d, ISNI 0000 0001 1033 6139, Department of Anesthesiology, , Yokohama City University, ; Yokohama, Japan
                [141 ]GRID grid.260969.2, ISNI 0000 0001 2149 8846, Department of Acute Medicine, Division of Emergency and Critical Care Medicine, , Nihon University School of Medicine, ; Tokyo, Japan
                [142 ]GRID grid.412342.2, ISNI 0000 0004 0631 9477, Department of Intensive Care, , Okayama University Hospital, ; Okayama, Japan
                [143 ]GRID grid.26091.3c, ISNI 0000 0004 1936 9959, Department of Anesthesiology, , Keio University School of Medicine, ; Tokyo, Japan
                [144 ]GRID grid.415988.9, ISNI 0000 0004 0471 4457, Department of Intensive Care Medicine, , Miyagi Children’s Hospital, ; Sendai, Japan
                [145 ]GRID grid.252427.4, ISNI 0000 0000 8638 2724, Department of Emergency Medicine, , Asahikawa Medical University, ; Asahikawa, Japan
                [146 ]GRID grid.415161.6, ISNI 0000 0004 0378 1236, Department of Cardiology, , Fukuyama City Hospital, ; Fukuyama, Japan
                [147 ]Department of General Internal Medicine, Koga General Hospital, Koga, Japan
                [148 ]GRID grid.416629.e, ISNI 0000 0004 0377 2137, Department of Anesthesiology, , Osaka Women’s and Children’s Hospital, ; Izumi, Japan
                [149 ]Fukuoka Prefectural Psychiatric Center, Dazaifu Hospital, Dazaifu, Japan
                [150 ]GRID grid.264706.1, ISNI 0000 0000 9239 9995, Department of Emergency Medicine, , Teikyo University School of Medicine, ; Tokyo, Japan
                [151 ]GRID grid.411248.a, ISNI 0000 0004 0404 8415, Emergency and Critical Care Center, , Kyushu University Hospital, ; Fukuoka, Japan
                [152 ]GRID grid.411152.2, ISNI 0000 0004 0407 1295, Department of Intensive Care Medicine, , Kumamoto University Hospital, ; Kumamoto, Japan
                [153 ]Department of Anesthesiology and Intensive Care Unit, Todachuo General Hospital, Toda, Japan
                [154 ]GRID grid.26091.3c, ISNI 0000 0004 1936 9959, Department of Pediatrics, , Keio University School of Medicine, ; Tokyo, Japan
                [155 ]Department of Emergency and Critical Care Medicine, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
                [156 ]GRID grid.261356.5, ISNI 0000 0001 1302 4472, Department of Emergency, Critical Care, and Disaster Medicine, , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, ; Okayama, Japan
                [157 ]Intensive Care Unit, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
                [158 ]GRID grid.416089.2, Department of Respiratory Medicine, , Tokyo Yamate Medical Center, ; Tokyo, Japan
                [159 ]Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
                [160 ]GRID grid.413410.3, Department of Anesthesiology and Critical Care Medicine, , Nagoya Daini Red Cross Hospital, ; Nagoya, Japan
                [161 ]GRID grid.415804.c, ISNI 0000 0004 1763 9927, Department of Emergency Medicine and Intensive Care Medicine, , Shizuoka General Hospital, ; Shizuoka, Japan
                [162 ]GRID grid.258799.8, ISNI 0000 0004 0372 2033, Department of Preventive Services, , Kyoto University Graduate School of Medicine, ; Kyoto, Japan
                [163 ]GRID grid.260975.f, ISNI 0000 0001 0671 5144, Division of Emergency and Critical Care Medicine Niigata University Graduate School of Medical and Dental Science, ; Niigata, Japan
                [164 ]GRID grid.482668.6, ISNI 0000 0004 1769 1784, Department of Emergency and Critical Care Medicine, , Juntendo University Nerima Hospital, ; Tokyo, Japan
                [165 ]GRID grid.416948.6, ISNI 0000 0004 1764 9308, Department of Pediatric Critical Care Medicine, , Osaka City General Hospital, ; Osaka, Japan
                [166 ]GRID grid.416684.9, ISNI 0000 0004 0378 7419, Department of Emergency and Critical Care Medicine, , Saiseikai Utsunomiya Hospital, ; Utsunomiya, Japan
                [167 ]GRID grid.411582.b, ISNI 0000 0001 1017 9540, Research Associate of Minimally Invasive Surgical and Medical Oncology, , Fukushima Medical University, ; Fukushima, Japan
                [168 ]GRID grid.414936.d, ISNI 0000 0004 0418 6412, Department of Emergency Medicine, , Japanese Red Cross Society Wakayama Medical Center, ; Wakayama, Japan
                [169 ]Department of Emergency Medicine, Saitama Saiseikai Kurihashi Hospital, Kuki, Japan
                [170 ]GRID grid.413411.2, Division of Intensive Care Unit, , Sakakibara Heart Institute, ; Tokyo, Japan
                [171 ]GRID grid.416684.9, ISNI 0000 0004 0378 7419, Department of Emergency Medicine and Critical Care Medicine, Tochigi Prefectural Emergency and Critical Care Center, , Imperial Foundation Saiseikai Utsunomiya Hospital, ; Utsunomiya, Japan
                [172 ]GRID grid.416532.7, ISNI 0000 0004 0569 9156, Department of Anesthesiology, , St. Mary’s Hospital, Our Lady of the Snow Social Medical Corporation, ; Kurume, Japan
                [173 ]GRID grid.415604.2, ISNI 0000 0004 1763 8262, Department of Emergency and Critical Care Medicine, , Japanese Red Cross Kyoto Daiichi Hospital, ; Kyoto, Japan
                [174 ]GRID grid.411248.a, ISNI 0000 0004 0404 8415, Department of Critical Care Medicine, , Kyushu University Hospital, ; Fukuoka, Japan
                [175 ]GRID grid.258799.8, ISNI 0000 0004 0372 2033, Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, , Kyoto University, ; Kyoto, Japan
                [176 ]Department of Intensive Care, Chiba Emergency Medical Center, Chiba, Japan
                [177 ]Department of Internal Medicine, Kanazawa Municipal Hospital, Kanazawa, Japan
                [178 ]Ishikawa Prefectual Central Hospital Emergency and Critical Care Center, Kanazawa, Japan
                [179 ]Department of Emergency and General Internal Medicine, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
                [180 ]GRID grid.410714.7, ISNI 0000 0000 8864 3422, Department of Emergency and Disaster Medicine, , Showa University, ; Tokyo, Japan
                [181 ]GRID grid.417092.9, Department of Cardiology, , Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, ; Tokyo, Japan
                [182 ]GRID grid.410843.a, ISNI 0000 0004 0466 8016, Department of Emergency Medicine, , Kobe City Medical Center General Hospital, ; Kobe, Japan
                [183 ]Department of Critical Care and Emergency Medicine, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan
                [184 ]GRID grid.416614.0, ISNI 0000 0004 0374 0880, Department of Traumatology and Critical Care Medicine, , National Defense Medical College, ; Tokorozawa, Japan
                [185 ]GRID grid.413114.2, Department of Emergency Medicine, , University of Fukui Hospital, ; Fukui, Japan
                [186 ]GRID grid.414159.c, ISNI 0000 0004 0378 1009, Pharmaceutical Department, , JA Hiroshima General Hospital, ; Hatsukaichi, Japan
                Article
                555
                10.1186/s40560-021-00555-7
                8384927
                34433491
                58b6236f-9a66-410e-a5a2-99192b319621
                © The Author(s) 2021

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                History
                : 26 April 2021
                : 10 May 2021
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                © The Author(s) 2021

                evidence-based medicine,grade,guidelines,sepsis,septic shock,systematic review

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