2026 SSC Children Guidelines Updates: What Clinicians Need to Know-Surviving Sepsis Campaign Children's Guidelines: 2026 Update

Video Transcription

Video Summary

This webcast presented key updates from the 2026 Surviving Sepsis Campaign Pediatric Guidelines, emphasizing that most recommendations remain based on low/very low-certainty evidence. Prof. Tex Kissoon reviewed hemodynamic resuscitation: in systems with ICU access, give 40–60 mL/kg in 10–20 mL/kg boluses during the first hour for septic shock; in sepsis without hypotension and no ICU, avoid bolus fluids and use maintenance; in hypotensive septic shock without ICU, give up to 40 mL/kg. Reassess after each bolus and stop if shock resolves or fluid overload develops. Balanced crystalloids are suggested over normal saline; crystalloids over albumin. Resuscitation should be guided by clinical markers, with optional targeting of ScvO₂ >70% if central access is available. Point-of-care/cardiac ultrasound is suggested where training/resources exist. Evidence is insufficient on timing of vasoactives vs fluids and on a preferred first-line agent, but starting vasoactives peripherally is suggested rather than delaying for central access.<br /><br />Prof. Pierre Tissières covered adjuncts: insufficient evidence for intubation solely for shock; avoid etomidate. A new recommendation suggests conservative post-resuscitation SpO₂ targets (88–92%) in many patients. Hydrocortisone is suggested against in stable patients; evidence is insufficient in refractory shock. Active management of fluid overload is endorsed; high-volume hemofiltration is now suggested over standard volume. Evidence remains insufficient for plasma exchange, blood purification, and many immunotherapies; IVIG is not recommended routinely. A new post-ICU section suggests early individualized rehabilitation and highlights post-sepsis morbidity surveillance and family education.

Keywords

2026 Surviving Sepsis Campaign

pediatric sepsis guidelines

septic shock fluid resuscitation

balanced crystalloids vs normal saline

peripheral vasoactive initiation

post-resuscitation oxygen saturation target 88-92%

post-ICU rehabilitation and post-sepsis morbidity surveillance

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