Sepsis and Organ Dysfunction: An Overview of the New Science and New Biology
What is new and exciting in the new millennium about sepsis? Do we know more about it? Yes, and that is new and exciting. Do we know more about the contributions of sepsis and mediators to organ dysfunction? Yes, and that is new and exciting. Can we use this exciting information to better care for our patients? Not yet. Thus, there is a large discrepancy between how much we know and what we can do. This is a challenge. There are a number of reasons for the gulf between what we know and what we can do . The excitement of molecular biology, genomic studies, and the human genome project cannot as yet be translated into clinical usefulness . The process of science dissects phenomena and mediators — studies them in isolation — as in genetically pure animals or knockout mice with well-controlled experiments and only one variable. In patient care things are complex. Patients differ in age, sex, ethnicity, prior illness, chronic illness, genetic background, and life (antigen) experiences. These differences are becoming clearer as we learn of genetic polymorphisms and antigen exposures . Sepsis is not a diagnosis or a disease and you cannot treat it. An infection which has become systemic should be called that — an infection with systemic manifestations.
KeywordsOrgan Dysfunction Systemic Inflammatory Response Syndrome Acute Respiratory Distress Syndrome Nosocomial Infection Multiple Organ Failure
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- 15.Morell V (1997) Antibiotic resistance: road of no return. Science 278: 575–576Google Scholar
- 22.D’Agata EMC, Venkataraman L, DeGirolami P et al (1999) Colonization with broad-spectrum cephalosporin-resistant Gram-negative bacilli in intensive care units during a nonoutbreak period: prevalence, risk factors, and rate of infection. 27: 1090–1095Google Scholar
- 33.Morell V (1997) Antibiotic resistance: road of no return. Science 278: 575–576Google Scholar
- 34.Heeg K, Miethke T, Wagner H (1996) Superantigen-mediated lethal shock: the functional state of ligand-reactive T cells. In: Heeg K, Miethke T, Wagner H (eds) Current topics of microbiology. Springer-Verlag, Heidelberg Berlin New York, pp 83–100Google Scholar
- 50.Braga M, Vignali A, Gianotti L et al (1995) Benefits of early postoperative enterai feeding in cancer patients. Infusionsther Tranfusionsmed 22: 280–284Google Scholar
- 57.Schultz SG (1996) Homeostasis, humpty-dumpty and integrative biology. News Physiol Sci 11: 238–246Google Scholar