ABSTRACT
Sepsis, septic shock, and their sequelae are unquestionably a major contributor to
morbidity and mortality in hospitalized patients worldwide. Severe sepsis often
punctuates the terminal phase of illness due to a multitude of underlying
disease conditions in patients both young and old. Severe sepsis/septic shock is recognized as one of the leading causes of death in developed countries (1),
and the frequency of severe sepsis is clearly increasing in North America,
Europe, and many other countries throughout the world (1,2). The problem of
sepsis has been recognized for over a century by astute clinicians who recognized
that many patients were dying from severe infection as a result of a deleterious
host response to the infection, rather than from direct invasion of the microbial
pathogen into the tissues of the patient. As a result of innovations and advances
in medicine and surgical technique, sepsis has become “a disease of medical pro-
gress.” The ever-increasing incidence of sepsis is related in large part to
improved survival rates from other reversible causes of lethality, such as blood
loss, volume depletion, trauma, many cancers, and a variety of other disease pro-
cesses that were rapidly fatal even a few human generations ago. These advances
in medicine and surgery provide a large number of severely injured, hospitalized
patients who remain susceptible to morbidity and mortality from severe sepsis/ septic shock (3,4).
