文档介绍：广州市妇女儿童医疗中心
广州市儿童医院PICU 杨镒宇
解读2008年脓毒血症与感染性休克 管理国际指南(儿科部分) 广州,
Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008
Surviving Sepsis Campaign历史
© Society of Critical Care Medicine 2007
The article will also be published in Critical
Care Medicine.
Sponsor of 2004 guidelines;
Sponsor of 2008 guidelines but did not participate
formally in revision process;
Members of the 2007 SSC mittee
are listed in Appendix I.;
Please see Appendix J for author disclosure
information.
广州市妇女儿童医疗中心
跨洲、跨国的多中心联合
anizations: American Association of Critical-Care Nurses*,
American College of Chest Physicians*,
American College of Emergency Physicians*,
Canadian Critical Care Society,
European Society of Clinical Microbiology and Infectious Diseases*,
European Society of Intensive Care Medicine*,
European Respiratory Society*,
International Sepsis Forum*,
Japanese Association for Acute Medicine,
Japanese Society of Intensive Care Medicine,
Society of Critical Care Medicine*,
Society of Hospital Medicine**,
Surgical Infection Society*,
World Federation of Societies of Intensive and Critical Care
广州市妇女儿童医疗中心
Table 1 Determination of the Quality of Evidence
•Underlying methodology
A RCT
B Downgraded RCT or upgraded observational studies
C Well-done observational studies
D Case series or expert opinion
• Factors that may decrease the strength of evidence
1. Poor quality of planning and implementation of available RCTs suggesting high likelihood of bias
2. Inconsistency of results (including problems with subgroup analyses)
3. Indirectness of evidence (differing population, intervention, control, es, comparison)
4. Imprecision of results
5. High likelihood of reporting bias
• Main factors that may increase the strength of evidence
1. Large magnitude of effect (direct evidence, relative risk (RR) >2 with no plausible confounders)
2. Very large magnitude of effect with RR >5 and no threats to validity (by two