Multiple Organ Dysfunction: The Defining Syndrome of Sepsis.

BACKGROUND: Sepsis as a process has been recognized since the time of the Ancient Greeks. The concept has evolved recently to reflect a disease process of a severe, systemic response to infection. Acute, life-threatening but potentially reversible organ dysfunction is its hallmark, and unresolving organ dysfunction is the dominant cause of death in critical illness. Its evolution, persistence, and resolution reflect a complex interplay of factors originating in the initial inciting insult, the innate immune and metabolic response of the host, and the beneficial and harmful consequences of intensive care unit (ICU) supportive care. DISCUSSION: We describe the common clinical manifestations of the six prototypic organ system dysfunction syndromes of severe sepsis and review the associated epidemiology and suspected pathophysiology.