Current concepts for the reduction of mortality in severe sepsis and multiple organ failure

In the past few years, considerable progress has been made in the development of therapeutic concepts to reduce mortality in sepsis and septic shock. Some of these approaches attempt to modulate or interrupt the cascade effects of sepsis in order to stop the causes of multiple organ failure (e.g. TNF-alpha antibodies, high-flow haemofiltration, antielastases, modulators of coagulation), while others focus on the improvement of ICU management of organ dysfunction. This review reports about four new concepts, presented on the 32nd Congress of the Society of Critical Care Medicine (SCCM, San Antonio/Texas, USA, 28(th) January - 2(nd) February 2003) as very apt and promising new interventions for the ICU setting to decrease the unacceptably high mortality rate in patients with severe sepsis.