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Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Immunology

Background:

  • Sepsis was historically defined by infection and signs like fever and elevated leukocytes.
  • Current understanding views sepsis as a systemic inflammatory and immune response to infection, leading to organ injury.
  • Septic shock involves hypotension and hyperlactatemia, carrying high in-hospital mortality rates.

Purpose of the Study:

  • To review the evolving definition and understanding of sepsis.
  • To discuss the shift in sepsis from an acute to a chronic critical illness.
  • To highlight challenges in sepsis management and outcome prediction.

Main Methods:

  • Literature review and synthesis of current understanding of sepsis.
  • Analysis of historical and contemporary definitions of sepsis and septic shock.
  • Discussion of clinical outcomes, including mortality and long-term sequelae.

Main Results:

  • Sepsis is increasingly recognized as a dysregulated immune response with declining mortality rates (15-25%).
  • Septic shock mortality remains high (30-50%), requiring vasopressors.
  • Survivors face long-term risks, including mortality, cognitive, and functional deficits.

Conclusions:

  • Sepsis is a complex chronic critical illness with prolonged inflammation and immune suppression.
  • Despite improved recognition and care, immunomodulatory treatments have shown limited success.
  • No definitive sepsis biomarker exists, and outcome prediction remains challenging.