{"id":19,"date":"2015-07-02T11:22:38","date_gmt":"2015-07-02T02:22:38","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=19"},"modified":"2015-08-06T11:23:05","modified_gmt":"2015-08-06T02:23:05","slug":"%e6%95%97%e8%a1%80%e7%97%87%e3%81%ae%e6%b2%bb%e7%99%82%e6%96%b9%e9%87%9d%ef%bc%88early-goal-directed-therapy%ef%bc%9aegdt%ef%bc%89%e3%81%af%e6%99%82%e4%bb%a3%e9%81%85%e3%82%8c%e3%81%aa%e3%81%ae","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=19","title":{"rendered":"\u6557\u8840\u75c7\u306e\u6cbb\u7642\u65b9\u91dd\uff08Early goal-directed therapy\uff1aEGDT\uff09\u306f\u6642\u4ee3\u9045\u308c\u306a\u306e\u304b"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nLing Zhang, Guijun Zhu, Li Han and Ping Fu \uff0eEarly goal-directed therapy in the management of severe sepsis or septic shock in adults: a meta-analysis of randomized controlled trials\uff1aBMC Medicine (2015) 13:71<\/p>\n

\u2015\u8981\u7d04\u2015
\n\u3010\u80cc\u666f\u3011
\n\u3000The Surviving Sepsis Campaign\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\u3001early goal-directed therapy (EGDT) \u304c\u3001\u91cd\u75c7\u6557\u8840\u75c7\u307e\u305f\u306f\u6557\u8840\u75c7\u6027\u30b7\u30e7\u30c3\u30af\u306e\u60a3\u8005\u306e\u81f4\u6b7b\u7387\u3092\u4e0b\u3052\u308b\u91cd\u8981\u306a\u6226\u7565\u3060\u3068\u3057\u3066\u3044\u308b\u3002\u3057\u304b\u3057\u306a\u304c\u3089\u3001\u305d\u306e\u52b9\u679c\u306f\u4e0d\u660e\u3067\u3042\u308b\u3002<\/p>\n

\u3010\u65b9\u6cd5\u3011
\n\u30001966\u5e741\u6708\u304b\u30892014\u5e7410\u6708\u307e\u3067\u306eMedline, Embase, the Cochrane Library, Google Scholar, Chinese database (SinoMed)\u3068\u3044\u3063\u305f\u30c7\u30fc\u30bf\u30d9\u30fc\u30b9\u306b\u3042\u308b\u6587\u732e\u3092\u6e09\u731f\u3057\u305f\u3002
\n\u91cd\u75c7\u6557\u8840\u75c7\u307e\u305f\u306f\u6557\u8840\u75c7\u6027\u30b7\u30e7\u30c3\u30af\u306b\u5bfe\u3059\u308bEGDT\u306b\u95a2\u3059\u308b\u5168\u3066\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306b\u3064\u3044\u3066\u3001\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u304a\u3088\u3073\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3092\u884c\u3063\u305f\u3002\u30d7\u30e9\u30a4\u30de\u30ea\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u3057\u3066\u306f\u81f4\u6b7b\u7387\u3001\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u3057\u3066\u306fICU\u6ede\u5728\u671f\u9593\u3001\u5165\u9662\u671f\u9593\u3001\u4eba\u5de5\u547c\u5438\u5668\u7ba1\u7406\u3001\u6607\u5727\u5264\u3001\u8f38\u6db2\u3001\u8f38\u8840\u3068\u3057\u305f\u3002Review Manager 5.2\u3092\u7528\u3044\u3066\u3001\u76f8\u5bfe\u30ea\u30b9\u30af\u300195%\u4fe1\u983c\u533a\u9593\u3092\u7b97\u51fa\u3057\u305f\u3002<\/p>\n

\u3010\u7d50\u679c\u3011
\n\u30002011\u5e74\uff5e2014\u5e74\u307e\u3067\u306e10\u306eRCT\u30014157\u4eba\u306e\u60a3\u8005\u3092\u7d44\u307f\u5165\u308c\u305f\u3002\u5168\u3066\u306e\u7814\u7a76\u3067\u3001EGDT\u7fa4\u3068\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u7fa4\u3067\u306f\u81f4\u6b7b\u7387\u306b\u6709\u610f\u5dee\u3092\u8a8d\u3081\u306a\u304b\u3063\u305f\uff08RR 0.91, 95% CI: 0.79 to 1.04,P = 0.17\uff09\u3002\u7570\u8cea\u6027\u306e\u691c\u5b9a\u3067\u306f\u03c72 = 23.65, I2 = 58%\u3067\u3042\u3063\u305f\u3002\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790\u3067\u306f\u3001\u6a19\u6e96EGDT\u7fa4\uff08\u6ce81\uff09\u306f\u3001\u4fee\u6b63EGDT\u7fa4\uff08\u6ce82\uff09\u3068\u9055\u3063\u3066\u3001\u901a\u5e38\u6cbb\u7642\uff08\u6ce83\uff09\u306b\u6bd4\u8f03\u3057\u3066\u4f4e\u3044\u81f4\u6b7b\u7387\u3060\u3063\u305f\uff08RR 0.84, 95%\u3000CI: 0.72 to 0.98, P = 0.03\uff09\u3002\u3057\u304b\u3057\u306a\u304c\u3089\u3001EGDT\u7fa4\u306f\u3001\u65e9\u671f\u306b\u4e73\u9178\u9664\u53bb\u3092\u3057\u305f\u7fa4\u3068\u6bd4\u8f03\u3057\u3001\u3088\u308a\u9ad8\u3044\u81f4\u6b7b\u7387\u3067\u3042\u3063\u305f\uff08RR 1.52, 95% CI: 1.06 to 2.18, P = 0.02\uff09\u3002\u6700\u521d\u306e6\u6642\u9593\u3067\u3001EGDT\u7fa4\u306f\u901a\u5e38\u6cbb\u7642\u306b\u6bd4\u8f03\u3057\u3066\u3001\u3088\u308a\u6607\u5727\u5264\u304c\u6295\u4e0e\u3055\u308c\u3001\u8f38\u6db2\u3055\u308c\u3001\u8f38\u8840\u3092\u3055\u308c\u3066\u3044\u305f\u3002ICU\u6ede\u5728\u671f\u9593\u3001\u5165\u9662\u671f\u9593\u3001\u6c17\u7ba1\u633f\u7ba1\u7387\u3001\u6607\u5727\u5264\u6295\u4e0e\u306b\u3064\u3044\u3066\u306f\u6709\u610f\u5dee\u3092\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002<\/p>\n

\u6ce81\uff1a\u6a19\u6e96EGDT…\u6cbb\u7642\u958b\u59cb6\u6642\u9593\u4ee5\u5185\u306eCVP8\uff5e12mmHg\u3001\u5e73\u5747\u8840\u572765\uff5e90mmHg\u3001\u5c3f\u91cf0.5ml\/kg\/h\u4ee5\u4e0a\u3001\u4e2d\u5fc3\u9759\u8108\u9178\u7d20\u98fd\u548c\u5ea6\uff08ScvO2\uff0970%\u4ee5\u4e0a\u3092\u4fdd\u3064\u65b9\u7565
\n\u6ce82\uff1a\u4fee\u6b63EGDT…\u6a19\u6e96EGDT\u3092\u7c21\u7d20\u5316\u3057\u305f\u3082\u306e\uff08CVP\u3001ScvO2\u3092\u8a08\u6e2c\u3057\u306a\u3044\uff09
\n\u6ce83\uff1a\u901a\u5e38\u6cbb\u7642…\u5143\u6587\u732e\u306b\u3088\u308b\u304c\u3001\u304a\u304a\u3088\u305d\u8f38\u6db2\u91cf\u3001\u6607\u5727\u5264\u306e\u4f7f\u7528\u91cf\u306fEGDT\u306b\u6bd4\u3079\u3066\u5c11\u91cf<\/p>\n

\u3010\u7d50\u8ad6\u3011
\n\u3000EGDT\u306f\u3001\u91cd\u75c7\u6557\u8840\u75c7\u3001\u6557\u8840\u75c7\u6027\u30b7\u30e7\u30c3\u30af\u306e\u60a3\u8005\u306b\u3068\u3063\u3066\u751f\u547d\u4e88\u5f8c\u3092\u6539\u5584\u3057\u306a\u3044\u3088\u3046\u3067\u3042\u308b\u3002EGDT\u306f\u65e9\u671f\u4e73\u9178\u9664\u53bb\u7fa4\u3068\u6bd4\u8f03\u3057\u3066\u3088\u308a\u9ad8\u3044\u81f4\u6b7b\u7387\u3067\u3042\u3063\u305f\u3002\u65e9\u671f\u4e73\u9178\u9664\u53bb\uff08\u203b\uff09\u3092\u3059\u308bEGDT\u306b\u3064\u3044\u3066\u306e\u3001\u8cea\u306e\u9ad8\u3044RCT\u304c\u65bd\u884c\u3055\u308c\u308b\u3053\u3068\u304c\u671b\u307e\u3057\u3044\u3002<\/p>\n

\u203b\u4e73\u9178\u9664\u53bb\u6cbb\u7642…\u304a\u305d\u3089\u304f\u6301\u7d9a\u7684\u8840\u6db2\u900f\u6790\u6ffe\u904e\u6cbb\u7642\uff08CHDF\uff09\u306e\u3053\u3068\u3092\u6307\u3059<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n2015\u5e747\u67081\u65e5(\u6c34)<\/p>\n","protected":false},"excerpt":{"rendered":"

\u2015\u6587\u732e\u540d\u2015 Ling Zhang, Guijun Zhu, Li Han and Ping Fu \uff0eEarly goal-directed therapy in the management of severe seps … \u7d9a\u304d\u3092\u8aad\u3080 \u6557\u8840\u75c7\u306e\u6cbb\u7642\u65b9\u91dd\uff08Early goal-directed therapy\uff1aEGDT\uff09\u306f\u6642\u4ee3\u9045\u308c\u306a\u306e\u304b<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-19","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/19","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=19"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/19\/revisions"}],"predecessor-version":[{"id":20,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/19\/revisions\/20"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=19"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=19"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=19"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}