Management of Sepsis and Septic Shock 2026

- Research Gaps

Literature review shows insufficient research data that need further studies for:

-        The use of artificial intelligence (AI) as a tool for early screening and prediction of sepsis.

-        The efficacy, safety and cost-effectiveness of the newer modalities e.g.; ultrasound for cardiac output monitoring.

-        Research to identify sepsis phenotypes which may benefit from blood purification treatments.

-        Fluid resuscitation guided by dynamic measures in low-resource settings.

-        Further studies to inform about vasopressor selection and titration.

-        Studies to address the benefits of multimodal vasopressor strategies.

-        Studies to address the timing of adjunctive vasopressor initiation.

-        Studies needed for optimal timing for vasopressor initiation in sepsis-induced hypotension.

-        Studies to inform the optimal safety protocols for using peripheral vasopressors, including safe duration, maximal doses, peripheral IV access size, and peripheral IV anatomic location.

-        Trials needed to assess the impact of inotropes in sepsis, define which patients benefit, and determine optimal timing, dosing, and weaning strategies.

-        The use of active fluid removal and the use of ultrafiltration or extracorporeal fluid removal after the acute resuscitation phase in septic shock.