Septic shock

1. Septic shock is still a major complication of patients in intensive care units (ICUs) and, therefore, a main goal of ICU-related research. 2. After the unsatisfying results of multicenter clinical trials in blocking proinflammatory mediators such as tumor necrosis factor and interleukin-1 or endotoxin itself, research has focused on other important members of the cytokine pathways--in particular, anti-inflammatory cytokines such as interleukin 10. Moreover, there is an increasing knowledge of intracellular activation and deactivation pathways, inaugurating the theoretical advantage to block, attenuate or manipulate the inflammatory response at an early stage of disease or in a more specific fashion. 3. This review points out new developments in our understanding of the pathophysiology of septic shock and gives an example of a more recent approach in septic shock research--the heat shock response.