Sepsis, Sepsis Syndrome, and the Systemic Inflammatory Response Syndrome (SIRS)

Jonathan Swift'sGuillver's Travels, published in 1726, recounts the fictional adventures of Lemuel Gulliver, a ship's surgeon. Gulliver's most famous adventures are in Lilliput, the land of the little people, in Brobdingnag, the land of the giants, and in Houyhnhnm, the land of the horses. Less quoted is his adventure in Laputa where Gulliver, finding that science is out of control and not improving the lives of the citizens, condemns science. Current exploits in clinical trials regarding sepsis tempt the observer, like Gulliver, to condemn science, since intervention trials have found no benefit from anti-inflammatory therapies. However, out of apparent chaos often appears order: from these studies, our understanding of sepsis, sepsis syndrome, and the systemic inflammatory response syndrome (SIRS) is gradually increasing. See also p 117. In this issue ofThe Journal, Rangel-Frausto et al1provide a prospective validation of SIRS. They show that a diagnosis of SIRS