集中治療の巨人が日本の若手研究者へ贈るーProf Bellomo【JSICM50周年記念Oceania Week 再配信】
2025年5月13日
Professor Rinaldo Bellomoのご逝去を悼み、2023年7月に録画されたインタビューを再配信いたします。
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エビデンスに基づく医療（EBM）を導入し、患者のアウトカムを改善する医療を探求し続けるANZICS-CTGの30年の歴史から、常に人が信じるものを疑い、チームで協力して検証していくことの重要性を語ります。
*Prof Rinaldo Bellomo*
Austin Health (VIC, Australia) ICUリサーチディレクター・集中治療専門医
Monash大学公衆衛生大学院オーストラリア・ニュージーランド集中治療リサーチセンター（ANZIC-RC） 共同代表
ANZICS-CTG 設立代表者
Twitter (X) @BellomoRinaldo
*ANZICS-CTG*
https://www.anzics.com.au/clinical-trials-group/
*Dopamine trial*
Bellomo R et al. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group _ Lancet. _ 2000 Dec;356(9248):2139-43. doi: 10.1016/s0140-6736(00)03495-4.
https://pubmed.ncbi.nlm.nih.gov/11191541/
*The George Institute for Global Health*
https://www.georgeinstitute.org/
*SAFE trial*
Finfer S et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit _ N Engl J Med. _ 2004 May 27;350(22):2247-56. doi: 10.1056/NEJMoa040232.
https://pubmed.ncbi.nlm.nih.gov/15163774/
SAFE Study Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group; Australian Red Cross Blood Service; George Institute for International Health. Saline or albumin for fluid resuscitation in patients with traumatic brain injury _ N Engl J Med. _ 2007 Aug 30;357(9):874-84. doi: 10.1056/NEJMoa067514.
https://pubmed.ncbi.nlm.nih.gov/17761591/
*NICE-SUGAR trial*
NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients _ N Engl J Med. _ 2009 Mar 26;360(13):1283-97. doi: 10.1056/NEJMoa0810625.
https://pubmed.ncbi.nlm.nih.gov/19318384/
*RENAL trial*
RENAL Replacement Therapy Study Investigators. Intensity of continuous renal-replacement therapy in critically ill patients _ N Engl J Med. _ 2009 Oct 22;361(17):1627-38. doi: 10.1056/NEJMoa0902413.
https://pubmed.ncbi.nlm.nih.gov/19846848/
*ANZIC-RC*
NHMRC（オーストラリア政府による医療・公衆衛生の政策立案、関連する研究への資金提供を行う組織）とモナッシュ大学が共同出資して設立した研究専門組織でモナッシュ大学公衆衛生大学院の一部門
＊ANZICSとは異なる組織
https://www.monash.edu/medicine/sphpm/anzicrc
*【TAME program】*
Bellomo R et al. Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest _ Crit Care. _ 2011;15(2):R90. doi: 10.1186/cc10090.
https://pubmed.ncbi.nlm.nih.gov/21385416/
Schneider A et al. Arterial carbon dioxide tension and outcome in patients admitted to the intensive care unit after cardiac arrest _ Resuscitation. _ 2013 Jul;84(7):927-34. doi: 10.1186/cc10090.
https://pubmed.ncbi.nlm.nih.gov/23454258/
Eastwood GM et al. Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial) _ Resuscitation. _ 2016 Jul;104:83-90. doi: 10.1016/j.resuscitation.2016.03.023
https://pubmed.ncbi.nlm.nih.gov/21385416/
Eastwood GM et al. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest _ N Engl J Med. _ 2023 Jul 6;389(1):45-57. doi: 10.1056/NEJMoa2214552.
https://pubmed.ncbi.nlm.nih.gov/37318140/
*【Bicarbonate (SODa-BIC) program】*
Jude B et al. Sodium bicarbonate in 5% dextrose: can clinicians tell the difference? _ Crit Care Resusc. _ 2020 Mar;22(1):80-82.
https://pubmed.ncbi.nlm.nih.gov/32102646/
Naorungroj T et al. Stability of bicarbonate in normal saline: a technical report _ Crit Care Resusc. _ 2020 Mar;22(1):83-85.
https://pubmed.ncbi.nlm.nih.gov/32102647/
Mochizuki K et al. Acidemia subtypes in critically ill patients: An international cohort study _ J Crit Care _. 2021 Aug;64:10-17. doi: 10.1016/j.jcrc.2021.02.006.
https://pubmed.ncbi.nlm.nih.gov/33725556/
Fujii T et al. Incidence and management of metabolic acidosis with sodium bicarbonate in the ICU: An international observational study _ Crit Care. _ 2021 Feb 2;25(1):45. doi: 10.1186/s13054-020-03431-2.
https://pubmed.ncbi.nlm.nih.gov/33531020/
Serpa Neto A et al. Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a survey of Australian and New Zealand intensive care clinicians _ Crit Care Resusc. _ 2020 Sep;22(3):275-280.
https://pubmed.ncbi.nlm.nih.gov/32900336/
Fujii T et al. Sodium bicarbonate therapy for critically ill patients with metabolic acidosis: A scoping and a systematic review _ J Crit Care. _ 2019 Jun;51:184-191. doi: 10.1016/j.jcrc.2019.02.027.
https://pubmed.ncbi.nlm.nih.gov/30852347/
*MERCY trial*
Monti G et al. Continuous vs Intermittent Meropenem Administration in Critically Ill Patients With Sepsis: The MERCY Randomized Clinical Trial. _ JAMA _2023 Jul 11;330(2):141-151. doi: 10.1001/jama.2023.10598.
https://pubmed.ncbi.nlm.nih.gov/37326473/
＝
エビデンスに基づく医療（EBM）を導入し、患者のアウトカムを改善する医療を探求し続けるANZICS-CTGの30年の歴史から、常に人が信じるものを疑い、チームで協力して検証していくことの重要性を語ります。
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00:00 オープニング 01:39 EBMのはじまりとANZICS-CTG 30年の歴史 14:14 Bellomo 教授の原動力とメンター 17:40 時間やエネルギーのマネジメントについて 21:27 日本とオーストラリアの研究環境について 29:38 ソーシャルメディアでの発信について 33:37 診療の現場で臨床研究のテーマを考えることについて 37:06 AIが臨床研究に起こす変化について 42:52 これからの集中治療医・教育への期待 46:58 エンディング |
*Prof Rinaldo Bellomo*
Austin Health (VIC, Australia) ICUリサーチディレクター・集中治療専門医
Monash大学公衆衛生大学院オーストラリア・ニュージーランド集中治療リサーチセンター（ANZIC-RC） 共同代表
ANZICS-CTG 設立代表者
Twitter (X) @BellomoRinaldo
*ANZICS-CTG*
https://www.anzics.com.au/clinical-trials-group/
*Dopamine trial*
Bellomo R et al. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group _ Lancet. _ 2000 Dec;356(9248):2139-43. doi: 10.1016/s0140-6736(00)03495-4.
https://pubmed.ncbi.nlm.nih.gov/11191541/
*The George Institute for Global Health*
https://www.georgeinstitute.org/
*SAFE trial*
Finfer S et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit _ N Engl J Med. _ 2004 May 27;350(22):2247-56. doi: 10.1056/NEJMoa040232.
https://pubmed.ncbi.nlm.nih.gov/15163774/
SAFE Study Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group; Australian Red Cross Blood Service; George Institute for International Health. Saline or albumin for fluid resuscitation in patients with traumatic brain injury _ N Engl J Med. _ 2007 Aug 30;357(9):874-84. doi: 10.1056/NEJMoa067514.
https://pubmed.ncbi.nlm.nih.gov/17761591/
*NICE-SUGAR trial*
NICE-SUGAR Study Investigators. Intensive versus conventional glucose control in critically ill patients _ N Engl J Med. _ 2009 Mar 26;360(13):1283-97. doi: 10.1056/NEJMoa0810625.
https://pubmed.ncbi.nlm.nih.gov/19318384/
*RENAL trial*
RENAL Replacement Therapy Study Investigators. Intensity of continuous renal-replacement therapy in critically ill patients _ N Engl J Med. _ 2009 Oct 22;361(17):1627-38. doi: 10.1056/NEJMoa0902413.
https://pubmed.ncbi.nlm.nih.gov/19846848/
*ANZIC-RC*
NHMRC（オーストラリア政府による医療・公衆衛生の政策立案、関連する研究への資金提供を行う組織）とモナッシュ大学が共同出資して設立した研究専門組織でモナッシュ大学公衆衛生大学院の一部門
＊ANZICSとは異なる組織
https://www.monash.edu/medicine/sphpm/anzicrc
*【TAME program】*
Bellomo R et al. Arterial hyperoxia and in-hospital mortality after resuscitation from cardiac arrest _ Crit Care. _ 2011;15(2):R90. doi: 10.1186/cc10090.
https://pubmed.ncbi.nlm.nih.gov/21385416/
Schneider A et al. Arterial carbon dioxide tension and outcome in patients admitted to the intensive care unit after cardiac arrest _ Resuscitation. _ 2013 Jul;84(7):927-34. doi: 10.1186/cc10090.
https://pubmed.ncbi.nlm.nih.gov/23454258/
Eastwood GM et al. Targeted therapeutic mild hypercapnia after cardiac arrest: A phase II multi-centre randomised controlled trial (the CCC trial) _ Resuscitation. _ 2016 Jul;104:83-90. doi: 10.1016/j.resuscitation.2016.03.023
https://pubmed.ncbi.nlm.nih.gov/21385416/
Eastwood GM et al. Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest _ N Engl J Med. _ 2023 Jul 6;389(1):45-57. doi: 10.1056/NEJMoa2214552.
https://pubmed.ncbi.nlm.nih.gov/37318140/
*【Bicarbonate (SODa-BIC) program】*
Jude B et al. Sodium bicarbonate in 5% dextrose: can clinicians tell the difference? _ Crit Care Resusc. _ 2020 Mar;22(1):80-82.
https://pubmed.ncbi.nlm.nih.gov/32102646/
Naorungroj T et al. Stability of bicarbonate in normal saline: a technical report _ Crit Care Resusc. _ 2020 Mar;22(1):83-85.
https://pubmed.ncbi.nlm.nih.gov/32102647/
Mochizuki K et al. Acidemia subtypes in critically ill patients: An international cohort study _ J Crit Care _. 2021 Aug;64:10-17. doi: 10.1016/j.jcrc.2021.02.006.
https://pubmed.ncbi.nlm.nih.gov/33725556/
Fujii T et al. Incidence and management of metabolic acidosis with sodium bicarbonate in the ICU: An international observational study _ Crit Care. _ 2021 Feb 2;25(1):45. doi: 10.1186/s13054-020-03431-2.
https://pubmed.ncbi.nlm.nih.gov/33531020/
Serpa Neto A et al. Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a survey of Australian and New Zealand intensive care clinicians _ Crit Care Resusc. _ 2020 Sep;22(3):275-280.
https://pubmed.ncbi.nlm.nih.gov/32900336/
Fujii T et al. Sodium bicarbonate therapy for critically ill patients with metabolic acidosis: A scoping and a systematic review _ J Crit Care. _ 2019 Jun;51:184-191. doi: 10.1016/j.jcrc.2019.02.027.
https://pubmed.ncbi.nlm.nih.gov/30852347/
*MERCY trial*
Monti G et al. Continuous vs Intermittent Meropenem Administration in Critically Ill Patients With Sepsis: The MERCY Randomized Clinical Trial. _ JAMA _2023 Jul 11;330(2):141-151. doi: 10.1001/jama.2023.10598.
https://pubmed.ncbi.nlm.nih.gov/37326473/
