A 1-Hour Resuscitation Bundle for Prehospital Management of Septic Shock.

Randomized trialCritical care medicine· Aug 2026

A 1-Hour Resuscitation Bundle for Prehospital Management of Septic Shock.

Romain Jouffroy, Djillali Annane, Caroline Elie … and the Service d’Aide Médicale Urgente (SAMU) Save Sepsis study group

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Prehospital & RetrievalRandomized trialTreatmentQ1IF 3.4

Prehospital 1-hour resuscitation bundle did not significantly lower 28-day mortality in septic shock.

A 1-Hour Resuscitation Bundle for Prehospital Management of Septic Shock.

Romain Jouffroy … and the Service d’Aide Médicale Urgente (SAMU) Save Sepsis study group

Critical care medicine · Aug 2026 · Q1 in Critical Care

Purpose

To investigate the effect of a 1-hour resuscitation bundle, including early antibiotics, hemodynamic optimization with fluids and vasopressors as needed, and hydrocortisone therapy as needed, implemented in a prehospital setting by a mobile ICU (mobile ICU) team, on 28-day mortality in adults with septic shock.

Methods

Adults with suspected septic shock at the time of management by the prehospital mobile ICU team.

n = 398 participants

Results

trend toward fewer deaths with the bundle, but not statistically significant

risk ratio 0.81 (95% CI 0.61 to 1.08)

CI crosses the null - not significant

More results

The primary outcome was 28-day all-cause mortality.

Secondary outcomes included mortality rates in the ICU, at hospital discharge, and at 90 days, time alive free of vasopressor drugs, invasive mechanical ventilation, renal replacement therapy, and ICU and hospital lengths of stay.

More results

Of 398 participants, 17 did not consent; therefore, 381 participants (96%; mean age, 67 ± 15 yr) were analyzed.

The intracluster correlation coefficient was estimated at 0.005 ± 0.002.

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Conclusion · 1 of 2

The prehospital initiation of a 1-hour resuscitation bundle did not reduce 28-day all-cause mortality in adults with septic shock.

Conclusion · 2 of 2

Imbalances in patient enrollment between centers and a small difference in care provided between the groups may explain these results.

A 1-Hour Resuscitation Bundle for Prehospital Management of Septic Shock.

A 1-Hour Resuscitation Bundle for Prehospital Management of Septic Shock.

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