O pening the D ebate on the N ew S epsis D efinition Defining Sepsis: A Case of Bounded Rationality and Fuzzy Thinking?

The Sepsis-3 Task Force recently offered a conceptual definition of sepsis as life-threatening organ dysfunction secondary to a dysregulated host response to infection (1).As with prior definitions, the task force acknowledged there is no "gold standard" by which to operationalize this definition.Nonetheless, they believed there was a need to offer some standard and, based on several domains of validity, reliability, and practicality, recommended sepsis be defined clinically as an increase of two or more Sequential Organ Failure Assessment (SOFA) points in the setting of infection.The task force reached its recommendations after vigorous debate; opinions were not unanimous, and the subsequent reaction in the broader community reflects many of the same points of contention.Debate is welcomed, but one disconnect is the certainty with which some views have been expressed, despite the widely acknowledged uncertainties plaguing sepsis.