The 2026 Surviving Sepsis Campaign Guidelines: The dissenting opinion

The Surviving Sepsis Campaign (SSC) Guidelines once represented what was considered the pinnacle of care for patients with sepsis and septic shock. Unfortunately, over the past decade, successive iterations of the guidelines have drifted from what is now considered optimal care for critically ill patients with sepsis and septic shock. Moreover, the guidelines have shifted from recommendations intended to guide and support physicians based on the best available evidence, to mandated "bundles" which exert substantial influence over what is considered "standard of care" in sepsis management. This. Document is intended to serve as a refutation of sorts. A rebuttal to the most controversial and influential recommendations in the Surviving Sepsis Campaign Guidelines, while also offering guidance on how clinicians might move beyond the protocolized, metric-based care that has become the current standard promoted by the SSC and similar organizations.