Management of Sepsis and Septic Shock 2026

·        Be aware about the continuously changing issues of patient heterogeneity, variable control care, and lack of understanding about ideal configuration of interventions.

·        The variation in both ICU and post ICU management of critically ill patients increases the complexity of understanding and defining best practice.

·        We recommend discussing goals of care and prognosis with patients and families over no such discussion for adults with sepsis or septic shock.

·        Patient and family goals of care is matched to ways both to promote recovery/avoid complications/recurrence and to ensure care.

·        Not all patients are the same and understanding which patients ought to receive which interventions should be considered .

·        Not all healthcare delivery systems are the same– even within one system, some patients may be very well supported while others may not–really complicating what ‘control’ care looks like.

·        Lack of understanding about dosing and intensity of many of the proposed interventions, and when and whether they should be combined in packages is generally missing.

·        The principles of palliative care (which may include palliative care consultation based on clinician judgement) should be integrated into the treatment plan, when appropriate, to address patient and family symptoms and suffering.

·        For adult survivors who had received invasive mechanical ventilation >48 hr during hospitalization for sepsis or septic shock, we “suggest” offering physical rehabilitation services after hospital discharge.

·        Comprehensive medication reconciliation should be performed at transitions in care, including at ICU and hospital discharge for adults with sepsis or septic shock.

·        The healthcare system should be aware of what optimal care during the recovery period might look like for this patient population.

·        For adult survivors of sepsis or septic shock and their families, clinicians should provide information about the hospital stay, sepsis and related diagnoses, treatments, and common impairments after sepsis in the written and verbal discharge summary.

·        Health systems should implement strategies to execute advanced directives to patients being discharged from hospital after sepsis or septic shock. 

·        After hospital discharge health systems should facilitate assessment and follow-up for physical, cognitive, and emotional problems for sepsis or septic shock.

·        Patients who survive a protracted period of ICU care for sepsis require physical rehabilitation challenges and a way to organize and coordinate care as they typically face a long and complicated road to recovery and also great uncertainty to overcome.

·        We suggest offering services that support mental health for adult survivors of hospitalized patients with sepsis or septic shock. after hospital discharge.