Sepsis through the eyes of an engineer -- why treatments have succeeded and failed.

The sepsis syndrome is an old phenomenon. A destructive response to a system disturbance, it manifests as widespread inflammation. Over the past two centuries, biomedical research has identified triggers and described components of the pathways that underlie the sepsis syndrome. Attempts at translating these findings into preventive and therapeutic interventions have met with varying levels of success. In this chapter, we examine the history of sepsis science through an engineering lens. Patterned attempts to intervene in the natural history of the sepsis syndrome will be discussed in parallel with similar, hypothetical adjustments made to a model system from the engineering canon. This juxtaposition will facilitate our review of the history of sepsis science. Using the logic of systems engineering and network science, we propose a way forward.