Journal Club 血管拡張性ショックに対する 血圧管理 …
JournalClub 2018/03/13 2Intensive Care Med (2018) 44:12 21 3 4PhlugersArch 1987;410-449RBF (MAP) MAP 65mmHg 5Surviving sepsis campaign: international guidelines for managementof severe sepsis and septic shock: 2012. CritCare Med 41:580 637Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med 40:1795 1815 Intensive Care Med 42 65mmHg RCT SEPSISPAM trial OVATION trial 7N EnglJ Med 2014; 370:1583-1593Intensive Care Med (2016) 42:542 550SEPSISPAM trial8N EnglJ Med 2014; 370:1583-1593SEPSISPAM trialP 776 IHigh-TargetGroup(MAP80 85mmHg)CLow-Target Group (MAP65 70mmHg)O28 9 Primary outcome28 Secondary outcome90 Low-Targetgroup Adverse eventsHigh-TargetGroup 10OVATION trial 11Intensive Care Med (2016) 42:542 550OVATION trialP 118 70% IHigh-TargetGroup(MAP:75 80mmHg)CLow-Target Group (MAP:60-65mmHg)O MAP pilot trial 12 Primary outcome MAP 9mmHgClinical outcomeICU 28 6 Adverseeffects 131475 LowTargetGroup RCT
clinical questions 成人ショック症例で血圧目標を変化させることで 28日死亡率を低減しうるか 患者属性に応じ血圧目標を変えることで
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