Sepsis Today: Diagnostic Misconceptions and Failure of Uniform Treatment Principles

Sepsis remains a major contributor to global hospital mortality, yet current diagnostic criteria and treatment protocols often fail to account for the complexity of its pathophysiology—particularly when sepsis originates from pulmonary infections such as pneumonia. This review critically examines longstanding assumptions in the classification and management of sepsis, challenging the conventional systemic interpretation and highlighting the overlooked role of pulmonary circulation and lung-specific mechanisms. Drawing from both historical clinical insights and contemporary data, the article underscores the limitations of uniform therapeutic approaches and the misapplication of sepsis definitions in respiratory contexts. The analysis calls for a reevaluation of diagnostic models and advocates for a differentiated, physiology-based treatment paradigm, offering preliminary considerations for future clinical strategies.