Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026” consists of eight sections: screening and early management; infection; hemodynamics; respiratory support; adjunctive and additional therapies; and goals of care, transitions of care, and long-term outcomes, comprising a total of 79 items and 129 statements. The cornerstone of the updated guidelines remains the bundled care pathway, emphasizing "antimicrobial initiation within 1 hour, monitoring of lactate and capillary refill time, 30 mL/kg crystalloid resuscitation within 3 hours, and source control and ICU admission within 6 hours". It provides more comprehensive recommendations and suggestions for the pre-hospital, in-hospital, and post-hospital management of patients with sepsis and septic shock. The revised statements repeatedly underscore that interventions should be tailored to individual patient characteristics, clinical context, and resource availability, rather than adhering to a one-size-fits-all approach. However, the overall proportion of strong recommendations has decreased compared to previous iterations, while low-certainty evidence has significantly increased, with few recommendations for novel therapies. A comprehensive evaluation of the guidelines would be required following its implementation in clinical practice.
