The systemic septic response: multiple systems organ failure

Sepsis, which is the host response to one or more microorganisms, is probably best understood within the concept of activator-mediator-responder. The various forms of metabolic support work in all three areas. The best treatment is still prevention. The mortality rate has progressively fallen and is now in the range of 35 to 40 per cent. Appropriate nutritional support seems to have been an important factor in this reduction in mortality. There are many new areas of research that need to be evaluated, and many of these areas are now directed at regulatory aspects of the metabolic response.