私たちの考えるジャーナルクラブは、参加者が海外文献を和訳して発表し合うというような、単なる“抄読会”とは一線を画します。試験デザインから結論に至るまでの過程を常に批判的な視点でとらえ、同様の、あるいはそれ以上のエビデンスを自分たちの施設で獲得するにはプロトコールのどの部分を手直しすればよいかなど、現場主義に徹した討論の場を提供するのがJSEPTICのジャーナルクラブです。参考までに最近のレビューをお示しします。この臨場感に惹かれたなら、今すぐJSEPTICの門戸を叩いてください。
更新日: 2017/02/13
急性期脳出血に対する積極的降圧療法
Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage.
Qureshi AI, Palesch YY, Barsan WG, et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med. 2016 Sep 15;375(11):1033-43. PMID: 27276234
更新日: 2017/02/13
抗血小板薬内服中の非外傷性脳出血に対する血小板輸血は有効か
Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial.
Baharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet. 2016 Jun 25;387(10038):2605-13. PMID: 27178479
更新日: 2016/10/03
心臓外科術後AFのコントロール
Rate Control versus Rhythm Control for Atrial Fibrillation after Cardiac Surgery.
Gillinov AM, Bagiella E, Moskowitz AJ, et al. Rate Control versus Rhythm Control for Atrial Fibrillation after Cardiac Surgery. N Engl J Med. 2016 May 19;374(20):1911-21. PMID: 27043047
更新日: 2016/10/03
院外心停止とアミオダロン、リドカイン
Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest.
Kudenchuk PJ, Brown SP, Daya M, et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2016 May 5;374(18):1711-22. PMID: 27043165
更新日: 2016/06/13
敗血症に合併した心房細動の治療
Practice Patterns and Outcomes of Treatments for Atrial Fibrillation During Sepsis: A Propensity-Matched Cohort Study.
Walkey AJ, Evans SR, Winter MR, et al. Practice Patterns And Outcomes Of Treatments For Atrial Fibrillation During Sepsis: A Propensity-matched Cohort Study. Chest. 2016;149(1):74-83. PMID: 26270396
更新日: 2016/03/07
AHA CPRガイドライン2015 Part 8: Post-Cardiac Arrest Care
Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S465-82. PMID: 26472996
更新日: 2016/03/07
AHA CPRガイドライン2015 Part 7: Adult ACLS
Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Link MS, Berkow LC, Kudenchuk PJ, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S444-64. PMID: 26472995
更新日: 2016/01/05
周術期のワーファリンブリッジ
Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation.
Douketis JD, Spyropoulos AC, Kaatz S, et al. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. N Engl J Med. 2015 Aug 27;373(9):823-33. PMID: 26095867
更新日: 2015/11/30
回収可能型IVCフィルター
Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial.
Mismetti P, Laporte S, Pellerin O, et al. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial.JAMA. 2015 Apr 28;313(16):1627-35. PMID: 25919526
更新日: 2015/09/07
TAVIから1年後
Clinical outcomes at 1 year following transcatheter aortic valve replacement.
Holmes DR Jr, Brennan JM, Rumsfeld JS, et al. Clinical outcomes at 1 year following transcatheter aortic valve replacement. JAMA. 2015 Mar 10;313(10):1019-28. PMID: 25756438
更新日: 2014/06/27
非心臓手術患者のアスピリン
Aspirin in patients undergoing noncardiac surgery
Devereaux PJ1, Mrkobrada M, et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med. 2014 Apr 17;370(16):1494-503 PMID24679062
更新日: 2014/05/29
敗血症の血圧管理
High versus Low Blood-Pressure Target in Patients with Septic Shock
Pierre Asfar, M.D., Ph.D., Ferhat Meziani, M.D., et al. High versus Low Blood-Pressure Target in Patients with Septic Shock. N Engl J Med 2014; 370:1583-1593
更新日: 2014/03/03
PCI後の非心臓手術
Risk of major adverse cardiac events following noncardiac surgery in patients with coronary stents
Hawn MT, Graham LA,et al. Risk of major adverse cardiac events following noncardiac surgery in patients with coronary stents. JAMA. 2013 Oct 9;310(14):1462-72. PMID: 24101118
更新日: 2014/01/06
機械弁とダビガトラン
Dabigatran versus Warfarin in Patients with Mechanical Heart Valves
John W. Eikelboom, M.D., Stuart J. Connolly, M.D.Dabigatran versus Warfarin in Patients with Mechanical Heart Valves. N Engl J Med 2013 Sep 26; 369:1206-1214. PMID: 23991661
更新日: 2012/03/05
sepsisと心房細動
Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis.
Walkey AJ, Wiener RS, Ghobrial JM, et al. Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA. 2011 Nov 23;306(20):2248-54. Epub 2011 Nov 13. PMID: 22081378
更新日: 2012/01/16
胸痛患者に対するpredefined 2-h accelerated diagnostic protocol (ADP)
A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospectiveobservational validation study.
Than M, Cullen L, Reid CM, et al. A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospectiveobservational validation study. Lancet. 2011; 377: 1077-84. PMID: 21435709
更新日: 2011/12/05
院外心肺停止
1)除細動までの時間
2)Impedance threshold deviceを使用したCPR
1)Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest.
2)A trial of an impedance threshold device in out-of-hospital cardiac arrest.
更新日: 2011/11/28
ネシリチド
Effect of nesiritide in patients with acute decompensated heart failure.
O'Connor CM, Starling RC, Hernandez AF, et al. Effect of nesiritide in patients with acute decompensated heart failure. N Engl J Med. 2011; 365: 32-43. PMID: 21732835
更新日: 2011/11/21
黄色ブドウ球菌菌血症に経食道エコーは必要か
Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia.
Kaasch AJ, Fowler VG Jr, Rieg S, et al. Use of a simple Criteria Set for Guiding Echocardiography in Nosocomial Staphylococcus aureus Bacteremia. Clin Infect Dis. 2011; 53: 1-9. PMID: 21653295
更新日: 2011/11/07
心合併症の術後への影響
Mortality and Readmission of Patients With Heart Failure, Atrial Fibrillation, or Coronary Artery Disease Undergoing Noncardiac Surgery
van Diepen S, Bakal JA, McAlister FA, Mortality and Readmission of Patients With Heart Failure, Atrial Fibrillation, or Coronary Artery Disease Undergoing Noncardiac Surgery. Circulation. 2011; 124: 289-96. Epub 2011 Jun 27. PMID: 21709059
更新日: 2011/10/31
septic shokの輸液療法
Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality.
Boyd JH, Forbes J, Nakada TA, et al. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011; 39: 259-65. PMID: 20975548
更新日: 2011/10/31
心不全での利尿薬
Diuretic strategies in patients with acute decompensated heart failure.
Felker GM, Lee KL, Bull DA, et al. Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med. 2011; 364: 797-805. PMID: 21366472
更新日: 2011/10/03
低体温療法
Influence of mild therapeutic hypothermia after cardiac arrest on hospital mortality
van der Wal G, Brinkman S, Bisschops LL, et al. Influence of mild therapeutic hypothermia after cardiac arrest on hospital mortality. Crit Care Med. 2011; 39: 84-8. PMID: 20959784
更新日: 2011/09/12
BNP測定のoutcome
Meta-analysis: effect of B-type natriuretic peptide testing on clinical outcomes in patients with acute dyspnea in the emergency setting.
Lam LL, Cameron PA, Schneider HG, et al. Meta-analysis: effect of B-type natriuretic peptide testing on clinical outcomes in patients with acute dyspnea in the emergency setting. Ann Intern Med. 2010; 153 : 728-35. PMID: 21135296
更新日: 2011/07/25
周術期心筋梗塞の特徴と予後
Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study.
Devereaux PJ, Xavier D, Pogue J, et al. Characteristics and short-term prognosis of perioperative myocardial infarction in patients undergoing noncardiac surgery: a cohort study. Ann Intern Med. 2011; 154: 523-8. PMID: 21502650
更新日: 2011/02/02
冠動脈バイパス手術時の輸血
Variation in use of blood transfusion in coronary artery bypass graft surgery.
Bennett-Guerrero E, Zhao Y, O'Brien SM, et al. Variation in use of blood transfusion in coronary artery bypass graft surgery. JAMA. 2010; 304: 1568-75. PMID: 20940382
更新日: 2010/08/18
The ROSE study
The Rose (Risk Stratification of Syncope in the Emergency Department) Study
Reed MJ, Newby DE, Coull AJ, et al. The Rose (Risk Stratification of Syncope in the Emergency Department) study. J Am Coll Cardiol. 2010; 55: 713-21. PMID: 20170806
更新日: 2010/07/16
pulmonary vascular dysfunctionの予後
Pulmonary vascular dysfunction is associated with poor outcomes in patients with acute lung injury
Bull TM, Clark B, McFann K, et al. Pulmonary vascular dysfunction is associated with poor outcomes in patients with acute lung injury. Am J Respir Crit Care Med. 2010; 182: 1123-8. PMID: 20558628
更新日: 2010/07/09
薬剤溶出ステントのダブル抗血小板療法
Duration of Dual Antiplatelet Therapy after Implantation of Drug-Eluting Stents
Park SJ, Park DW, Kim YH, et al. Duration of dual antiplatelet therapy after implantation of drug-eluting stents. N Engl J Med. 2010; 362: 1374-82. Epub 2010 Mar 15. PMID: 20231231
更新日: 2010/05/24
血管外科手術後のフルバスタチン
Fluvastatin and Perioperative Events in Patients Undergoing Vascular Surgery
Schouten O, Boersma E, Hoeks SE, et al. Fluvastatin and perioperative events in patients undergoing vascular surgery. N Engl J Med. 2009; 361: 980-9. PMID: 19726772
更新日: 2010/04/28
肺気腫、閉塞性肺疾患の進行は左室機能を悪くするか
Percent Emphysema, Airflow Obstruction, and Impaired Left Ventricular Filling
Barr RG, Bluemke DA, Ahmed FS, et al. Percent emphysema, airflow obstruction, and impaired left ventricular filling. N Engl J Med. 2010; 362: 217-27. PMID: 20089972
更新日: 2010/01/29
Dabigatranとワーファリン
Dabigatran versus Warfarin in Patients with Atrial Fibrillation
Nagarakanti R, Ezekowitz MD, Oldgren J, et al. Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion. Circulation. 2011 ;123: 131-6. Epub 2011 Jan 3. PMID: 21200007
更新日: 2010/01/27
diltiazemはアミオダロンやジゴキシンより良い。 -AFのレートコントロール-
Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation
Siu CW, Lau CP, Lee WL, et al. Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation. Crit Care Med. 2009; 37: 2174-9; quiz 2180. PMID: 19487941
更新日: 2009/11/04
周術期のβ遮断薬
Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis
Bangalore S, Wetterslev J, Pranesh S, et al. Perioperative beta blockers in patients having non-cardiac surgery: a meta-analysis. Lancet. 2008; 372: 1962-76. Epub 2008 Nov 13. PMID: 19012955