Prevention and Treatment of Sepsis - Present and Future Problems
What is wrong is that we have become lumpers — lumping together various human illnesses and injuries and attempting to treat them based upon certain general symptoms (SIRS, for example). This approach has not worked nor will it. What is right is that we are beginning to recognize this and we are becoming splitters. The evolution of Roger Bones thinking about this is worth reviewing. Early on he was excited about SIRS and MODS and developed concepts of CARS, MARS, and CHAOS . As more and more magic bullets failed, he progressively stressed the need to break down into separate units the problems you deal with within an ICU. From a lumper he was becoming a splitter. The day is over, or should be, when we attempt to treat a group of symptoms or signs which simply indicate that the patient is sick. This approach does not work.
KeywordsMigration Inhibitory Factor Adult Respiratory Distress Syndrome Cecal Ligation Magic Bullet Diethyl Maleate
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