Sepsis and Multiple Organ Failure: Consensus and Controversy

  • R. C. Bone
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 16)


Sepsis and its related sequelae, including sepsis, shock and multiple organ failure (MOF), are currently the subject of much discussion and some controversy. They are an important source of hospital morbidity and mortality; and a subject that all physicians should be familiar with-yet the pathogenesis of these diseases is still not fully understood. Research into their causes is progressing and new methods of diagnosis and treatment are being developed. In developing the protocols for clinical trials, and too, for basic research into the condition, investigators have run into an important problem: the terms used to describe the conditions have been imprecise or poorly defined. It is important that researchers be able to communicate with each other about their work, and that the knowledge gained through their work is disseminated efficiently and accurately to physicians. It is just as important that the physician dispensing health care to patients be able to accurately describe their condition. Thus, for people involved in medically diagnosing and treating sepsis and for those involved in researching sepsis, the terminology used to define various conditions that relate to sepsis is an important issue.


Septic Shock Severe Sepsis Systemic Inj7ammarory Response Syndrome Multiple Organ Failure Multiple Organ Dysfunction Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA, Balk RA, and the Methylpredni-solone Severe Sepsis Study Group (1987) A controlled clinical trial of highdose methylpred-nisolone in the treatment of severe sepsis and septic shock. N. Engl J Med 317:353–358CrossRefGoogle Scholar
  2. 2.
    Sprung CL, Caralis PV, Marcial EH, et al. (1984) The effects of high-dose corticosteroids in patients with septic shock: A prospective, controlled study. N Engl J Med 311:1137–1143PubMedCrossRefGoogle Scholar
  3. 3.
    The Veterans Administration Systemic Sepsis Comparative Study Group (1987) Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of sepsis. N Engl J Med 317:659–665CrossRefGoogle Scholar
  4. 4.
    Bone RC, Fisher CJ, Clemmer TJ, Slotman GJ, Metz CA, Balk RA, and the Methylpredniso-lone Severe Sepsis Study Group (1989) Sepsis syndrome: A valid clinical entity. Crit Care Med 17:389–393PubMedCrossRefGoogle Scholar
  5. 5.
    Parker MM, Parrillo JE (1983) Septic shock: Hemodynamics and pathogenesis. JAMA 250:3324–3327PubMedCrossRefGoogle Scholar
  6. 6.
    Young LS (1990) Gram-negative sepsis. In: Mandell GL, Douglas RG, Bennet JE (eds). Principles and Practice of Infectious Diseases, 3rd edition Churchill Livingston, New York, pp 611–636Google Scholar
  7. 7.
    Shubin H, Weil MH (1976) Bacterial shock. JAMA 235:421PubMedCrossRefGoogle Scholar
  8. 8.
    Bone RC (1991) Let’s agree on terminology: Defintions of sepsis. Crit Care Med 19:973PubMedCrossRefGoogle Scholar
  9. 9.
    Bone RC (1991) Sepsis, sepsis syndrome, multi-organ failure: A plea for comporable definitions. Ann Intern Med (Editorial) 114:332–333PubMedGoogle Scholar
  10. 10.
    Sprung CL (1991) Definitions of sepsis-Have we reached a consensus? Crit Care Med (Editorial) 19:849–851PubMedCrossRefGoogle Scholar
  11. 11.
    Canadian Multiple Organ Failure Study Group (1991) „Sepsis“-Clarity of existing termino-logy-or more confusion? Crit Care Med (Editorial) 19:996–998CrossRefGoogle Scholar
  12. 12.
    Bone RC, Fisher CJ, Clemmer TP, Slotman GJ, Metz CA and the Methylprednisolone Severe Sepsis Study Group (1987) Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. Chest 92:1032–1036PubMedCrossRefGoogle Scholar
  13. 13.
    Dunn D (1987) Immunotherapeutic advances in the treatment of gram-negative bacterial sepsis. World J Surg 11:233–240PubMedCrossRefGoogle Scholar
  14. 14.
    Cotran RS, Kumar V, Robbins SL (1989) In: Cotran RS, Kumar V, Robins SL (eds.)Rob-bins Pathologic Basis of Disease, 4th edition. W. B. Saunders, Philadelphia, pp 114–120Google Scholar
  15. 15.
    Cunnion RE, Parrillo JE (1989) Myocardial dysfunction in sepsis: Recent insights. Chest 95:941–945PubMedCrossRefGoogle Scholar
  16. 16.
    Knaus WA, Sun X, Nystrom PO, Wagner DP (1992) Evaluation of definition of sepsis. Chest (in press)Google Scholar
  17. 17.
    Bone RC, Fisher CJ Jr, Clemmer TP, et al. (1989) Sepsis syndrome: A valid clinical entity. Crit Care Med 17:389–393PubMedCrossRefGoogle Scholar
  18. 18.
    Rackow EC (1986) Clinical definition of sepsis and septic shock. In: WJ Sibbald, CL Sprung (eds) New Horizons: Perspectives on Sepsis and Septic Shock. Society of Critical Care Medicine, Fullerton, CA, pp 1–10Google Scholar
  19. 19.
    Pilz G, Werden K (1990) Cardiovascular parameters and scoring systems in the evaluation of response to therapy in sepsis and septic shock. Infection. 18:253PubMedCrossRefGoogle Scholar
  20. 20.
    The ACCP/SCCM Consensus Conference Committee (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101:1644–1655CrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1992

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  • R. C. Bone

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