Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026” consists of eight sections: screening and early management; infection; hemodynamics; respiratory support; adjunctive and additional therapies; and goals of care, transitions of care, and long-term outcomes, comprising a total of 79 items and 129 statements. The cornerstone of the updated guidelines remains the bundled care pathway, emphasizing "antimicrobial initiation within 1 hour, monitoring of lactate and capillary refill time, 30 mL/kg crystalloid resuscitation within 3 hours, and source control and ICU admission within 6 hours". It provides more comprehensive recommendations and suggestions for the pre-hospital, in-hospital, and post-hospital management of patients with sepsis and septic shock. The revised statements repeatedly underscore that interventions should be tailored to individual patient characteristics, clinical context, and resource availability, rather than adhering to a one-size-fits-all approach. However, the overall proportion of strong recommendations has decreased compared to previous iterations, while low-certainty evidence has significantly increased, with few recommendations for novel therapies. A comprehensive evaluation of the guidelines would be required following its implementation in clinical practice.
Objective To investigate the thirst status of patients in intensive care unit (ICU) who underwent oral tracheal intubation and ventilator assisted ventilation, and explore its influence factors. Methods A total of 172 patients with oral tracheal intubation admitted in ICU from June 2020 to September 2021 were investigated, and a numerical rating scale was employed for rating their thirst feelings. The patients were divided into a thirst group and a non-thirst group based on thirst status. The thirst status and influence factors of thirst distress were analyzed. Results The incidence of thirst in the ICU patients with oral tracheal intubation and ventilator assisted ventilation was 88.4%, and the thirst score in the thirst group was 7.70±1.17. Single factor analysis showed statistically significant difference between the two groups in sex, medical payment, smoking, drinking, duration of mechanical ventilation, humidification effect, sputum viscosity, gastrointestinal decompression, fasting, continuous renal replacement therapy, diuretics, 24-hour urine volume and liquid balance, heart function grading, sedatives, agitation, sweating, acute physiology and chronic health evaluation Ⅱ, endotracheal intubation depth, body mass index, PCO2, PO2, HCO3–, tidal volume, and sodium ion (all P<0.05). Multivariable regression analysis demonstrated that diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, intubation depth, and cardiac function were independent influence factors for the occurrence of thirst in the ICU patients who received tracheal intubation (P<0.01). Conclusions The incidence of thirst was high in ICU patients with airway intubation and ventilator assisted ventilation. Diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, 24-hour urine volume, and cardiac function grading were independent influence factors for the occurrence of thirst in ICU patients with tracheal intubation. It is necessary to implement targeted intervention to prevent and alleviate the thirst degree of patients, reduce the occurrence of related complications, and improve patient comfort.