Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.
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Weiss Scott L, Peters Mark J, Oczkowski Simon J W, Belley-Cote Emilie, Buysse Corinne, Choong Karen L M, Deep Akash, Inwald David P, Flori Heidi R, Kneyber Martin C J, Menon Kusum, Murthy Srinivas, Nunnally Mark E, Parker Margaret M, Schlapbach Luregn J, Oliveira Cláudio F, Sorce Lauren R, Agus Michael, Argent Andrew C, Balamuth Fran, Bansal Arun, Bem Reinout A, Brierley Joe, Burns Karen E A, Carlton Erin F, Carrol Enitan D, Carroll Christopher L, Carter Michael J, Conlon Thomas W, Daniels Robert, De Luca Daniele, Di Nardo Matteo, Dulfer Karolijn, Faust Saul N, Fernandez-Sarmiento Jaime, Fitzgerald Julie C, Hall Mark, Hsu Benson S, Javouhey Etienne, Joosten Koen, Karam Oliver, Kelly Serena P, Lang Hans-Joerg, Lee Jan Hau, Lemson Joris, MacLaren Graeme, Manning Joseph C, Mehta Nilesh, Morin Luc, Morrow Brenda M, Nadel Simon, Nishisaki Akira, Pong Sandra, Raman Sainath, Randolph Adrienne G, Ranjit Suchitra, Ray Samiran, Remy Kenneth E, Scott Halden F, Sick-Samuels Anna C, Souza Daniela C, Swan Tricia, Tibby Shane M, Valla Frederic V, Watson R Scott, Wiens Matthew O, Wolf Joshua, Zimmerman Jerry J, Tissieres Pierre, Kissoon Niranjan
Аннотация
DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads, as well as within subgroups, served as an integral part of the guideline development process.
METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate.
RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.
CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.