Sepsis: Preventing organ failure in sepsis - the search continues

Abstract

In a recent trial, levosimendan therapy failed to ameliorate sepsis-induced organ dysfunction or improve the survival of patients with septic shock. The failure of levosimendan and many other potential therapies for sepsis, together with the findings of histopathologic studies, raise questions regarding the pathophysiologic basis of the disorder.

Conflict of interest statement

Competing interests statement

R.S.H. has received grant support from Medimmune, Bristol-Myers Squibb, and GlaxoSmithKline. T.J.G. declares no competing interests.

Figures

Figure 1. Current theories of the pathophysiological mechanisms that underlie organ failure in sepsis

Three main theories exist: abnormal microcirculatory flow leading to cellular oxygen deficiency; inflammation-induced cell injury, protein breakdown and immunosuppression; cell hibernation and cell stunning (that is a switch to fetal gene expression and a low-energy state).