Table 1. Original and revised Surviving Sepsis Campaign (SSC) sepsis bundles.

Original SSC bundles based on the 2004 sepsis guidelines [5]	Revised SSC bundles based on the 2012 sepsis guidelines [4••]
6 h Resuscitation Bundle (to be completed within 6 h) Measure serum lactate concentration Obtain blood cultures prior to antibiotic administration Administer broad spectrum antibiotic within 3 h of emergency department (ED) admission and within 1 h of non-ED admission In the event of hypotension and/or serum lactate > 4 mmol/L: - Deliver an initial minimum of 20 mL/kg of crystalloid or equivalent - Administer vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mmHg In the event of persistent hypotension despite fluid resuscitation (septic shock) and/or lactate > 4 mmol/L: - Achieve a central venous pressure (CVP) of ≥ 8 mmHg - Achieve a central venous oxygen saturation (ScvO2) ≥ 70 % or mixed venous oxygen saturation (SvO2) ≥ 65 %	3 h Bundle (to be completed within 3 h) Measure lactate level Obtain blood cultures prior to administration of antibiotics Administer broad spectrum antibiotics Administer 30 mL/kg crystalloid for hypotension or lactate ≥ 4 mmol/L
	6 h Bundle (to be completed within 6 h) Apply vasopressors (for hypotension that does not respond to initial fluid resuscitation) to maintain a mean arterial pressure (MAP) > 65 mmHg In the event of persistent arterial hypotension despite volume resuscitation (septic shock) or initial lactate ≥ 4 mmol/L (36 mg/dL): - Measure central venous pressure (CVP)* - Measure central venous oxygen saturation (ScvO2)* Re-measure lactate if initial lactate was elevated*
	*Targets for quantitative resuscitation included in the guidelines are CVP of ≥ 8 mmHg, ScvO2 of ≥ 70 %, and normalization of lactate.
24 h Management Bundle (to be completed within 24 h) Administer low-dose steroids for septic shock in accordance with a standardized ICU policy. If not administered, document why the patient did not qualify for low-dose steroids based on the standardized protocol. Administer human activated protein C (rhAPC) in accordance with a standardized ICU policy. If not administered, document why the patient did not qualify for rhAPC. Maintain glucose control ≥ 70, but ≤ 150 mg/dL Maintain a median inspiratory plateau pressure (IPP) < 30 cmH2O for mechanically ventilated patients.	24 h Management Bundle no longer recommended