[Treatment of severe sepsis]

The sepsis syndrome is defined as a clinically suspected infection accompanied by systemic manifestations. The emergence of one or multiple organ dysfunctions is the hallmark of severe sepsis. The significance of sepsis in pulmonary medicine is highlighted by the fact that severe pneumonia is the most prevalent cause of sepsis in non-surgical intensive care medicine and that acute lung injury is among the prominent manifestations of severe sepsis. The formation of major study groups and competence centres during the last decade has made meaningful prospective interventional studies possible that, in turn, have resulted in the development of clinical treatment algorithms. Today, the multidisciplinary treatment of severe sepsis includes haemodynamic, respiratory, endocrine, immune, and coagulation aspects besides the control of the underlying infection. While new concepts of shock treatment and mechanical ventilation have been established by means of confirmatory studies, endocrine interventions as well as immune and anticoagulation procedures are still under investigation.