© 2009

Management of Sepsis: The PIRO Approach

  • Jordi Rello
  • Emili Díaz
  • Alejandro Rodríguez

Table of contents

  1. Front Matter
    Pages i-ix
  2. Jean-Louis Vincent
    Pages 1-9
  3. Rui P. Moreno, Ana Cristina Diogo, Susana Afonso
    Pages 11-22
  4. Emili Díaz, Thiago Lisboa
    Pages 39-49
  5. Thiago Lisboa, Alejandro Rodríguez, Jordi Rello
    Pages 51-63
  6. Malte Book, Lutz Eric Lehmann, Xiang Hong Zhang, Frank Stueber
    Pages 65-85
  7. Manel Luján, Yolanda Belmonte, Dionisia Fontanals
    Pages 87-96
  8. Javier Maynar Moliner, José Ángel Sánchez-Izquierdo Riera, Manuel Herrera Gutiérrez, Amaia Quintano Rodero, Alberto Manzano Ramirez
    Pages 97-116
  9. Jordi Almirall, Ester Vendrell, Javier de Gracia
    Pages 117-129
  10. Marcel Schouten, Tom van der Poll
    Pages 131-146
  11. Back Matter
    Pages 159-163

About this book


Sepsis is a very important public health problem. It is widely acknowledged that the severe inflammatory response syndrome/severe sepsis paradigm fails to stratify sepsis patients adequately. This book reviews in detail how sepsis should be managed on the basis of a novel approach to staging. The PIRO (predisposing factors, infection, response, organ dysfunction) model was first proposed at the start of the decade on a theoretical basis and has now been translated into a practical approach for use at the bedside. It is loosely based on the TNM staging system for cancers, with points being allocated to each of the four aforementioned key characteristics of the septic process. The proposed PIRO framework facilitates evaluation of factors that are important in the pathogenesis of severe sepsis and in the development of treatment strategies. This book clearly explains the advantages of the PIRO approach in different settings and will be of value to all practitioners concerned with the management of sepsis.


Atmen PIRO Pneumonia Sepsis Septic shock antibiotics infection

Editors and affiliations

  • Jordi Rello
    • 1
  • Emili Díaz
    • 1
  • Alejandro Rodríguez
    • 1
  1. 1.Intensive Care UnitJoan XXIII University HospitalTarragonaSpain

Bibliographic information

Industry Sectors
Health & Hospitals
Internal Medicine & Dermatology


From the reviews:

"This brief monograph describes the PIRO staging system … in the evaluation of severe infection along with current management of infection. Topics related to evaluation and management in sepsis are provided. Senior trainees and practitioners in academic settings are an appropriate audience for this work … . Line drawings and color highlights reproduce with excellent quality and good use is made of graphs and tables. … This is a worthwhile introduction to some of the recent developments in scoring and management of sepsis." (David J. Dries, Doody’s Review Service, October, 2009)