title: Sepsis: From Pathophysiology to Individualized Patient Care.
abstract: Sepsis has become a major health economic issue, with more patients dying in hospitals due to sepsis related complications compared to breast and colorectal cancer together. Despite extensive research in order to improve outcome in sepsis over the last few decades, results of large multicenter studies were by-and-large very disappointing. This fiasco can be explained by several factors, but one of the most important reasons is the uncertain definition of sepsis resulting in very heterogeneous patient populations, and the lack of understanding of pathophysiology, which is mainly based on the imbalance in the host-immune response. However, this heroic research work has not been in vain. Putting the results of positive and negative studies into context, we can now approach sepsis in a different concept, which may lead us to new perspectives in diagnostics and treatment. While decision making based on conventional sepsis definitions can inevitably lead to false judgment due to the heterogeneity of patients, new concepts based on currently gained knowledge in immunology may help to tailor assessment and treatment of these patients to their actual needs. Summarizing where we stand at present and what the future may hold are the purpose of this review.
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, University of Szeged, Szeged 6725, Hungary.
authors.forename: Ildikó
authors.initials: I
authors.lastname: László
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, University of Szeged, Szeged 6725, Hungary.
authors.forename: Domonkos
authors.initials: D
authors.lastname: Trásy
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, University of Szeged, Szeged 6725, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Molnár
authors.affiliation: Department of Transplantation and Surgery, Faculty of Medicine, Semmelweis University, Budapest 1082, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Fazakas
mesh_terms: D015415:Biomarkers; D002116:Calcitonin / Q000097:blood / Q000378:metabolism; D019468:Disease Management; D006801:Humans; D005791:Patient Care; D011498:Protein Precursors / Q000097:blood / Q000378:metabolism; D018805:Sepsis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; D002116:Calcitonin