Pathophysiology of the sepsis syndrome

Abstract

Sepsis is a common and important cause of mortality in our intensive care units (ICUs). Since the recognition that bacterial toxins were associated with infection, we have come a long way in our understanding of this condition and its pathophysiology. As research continues, we increasingly realize the complexity of the septic process, an appropriate and necessary body response to infection or insult, which can become excessive and detrimental if control is lost. The resultant uncontrolled immunological host response may lead, on a downward spiral, to tissue damage and multiple organ failure. Metaphorically, one could compare the septic process and its mediators to an army of soldiers, well regimented and organized, responding in a controlled manner to defend its territory against invasion. If some, or all, of these soldiers lose their normal disciplined control, fighting can become frenzied and unpredictable, endangering not only the invader, but also the territory that the army was defending.