Challenging the One-hour Sepsis Bundle

West J Emerg Med. 2019 Mar;20(2):185-190. doi: 10.5811/westjem.2018.11.39290. Epub 2019 Feb 4.


In April 2018, the Surviving Sepsis Campaign (SSC) released an updated sepsis bundle, which combines directives previously listed in the three-hour and six-hour bundles. The authors discussed the reasoning and evidence supporting these changes. However, there are data that suggest these recommendations may be contrary to the best available evidence. Our purpose here is to highlight the areas where evidence is only as strong as the methodological constructs of the research used. This article is a narrative review of the available, limited evidence on which the one-hour bundle was based.

Publication types

  • Review

MeSH terms

  • Guideline Adherence / statistics & numerical data
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Practice Guidelines as Topic
  • Sepsis / mortality
  • Sepsis / prevention & control*
  • Shock, Septic / mortality
  • Shock, Septic / prevention & control
  • Time-to-Treatment