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A correction has been published: N Engl J Med 2007;356(11):1178.

Previous Volume 355:1699-1713 October 19, 2006 Number 16 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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A better understanding of the inflammatory, procoagulant, and immunosuppressive aspects of sepsis has contributed to rational therapeutic plans from which several important themes emerge.¹ First, rapid diagnosis (within the first 6 hours) and expeditious treatment are critical, since early, goal-directed therapy can be very effective.² Second, multiple approaches are necessary in the treatment of sepsis.¹ Third, it is important to select patients for each given therapy with great care, because the efficacy of treatment — as well as the likelihood and type of adverse results — will vary, depending on the patient.

The Spectrum of Sepsis

Nomenclature is important when it helps us understand . . . [Full Text of this Article]

Pathophysiology

Innate Immunity and Inflammation in Early Sepsis

Specificity and Amplification of the Immune Response by Adaptive Immunity

Disturbance of Procoagulant–Anticoagulant Balance

Immunosuppression and Apoptosis in Late Sepsis

Sepsis and Widespread Organ Dysfunction

Treatment According to the Early and Later Stages of Sepsis

Early, Goal-Directed Therapy

Ventilation

Broad-Spectrum Antibiotics

Activated Protein C

Treatment of Anemia in Sepsis

Corticosteroids in Patients Who Require Critical Care

Evaluation and Control of the Source of Sepsis

Vasopressin

Hyperglycemia and Intensive Insulin Therapy

Renal Dysfunction and Dialysis

Support and General Care

Ineffective Therapies

Potential New Therapies

Summary

Source Information

From the University of British Columbia, Critical Care Medicine, St. Paul's Hospital, Vancouver, BC, Canada.

Address reprint requests to Dr. Russell at the University of British Columbia, Critical Care Medicine, St. Paul's Hospital, 1081 Burrard St., Vancouver, BC V6Z 1Y6, Canada, or at jrussell@mrl.ubc.ca.

Related Letters:

Management of Sepsis
Perel A., Segal E., Khurana A., Vinayek N., Mackenzie A. F., Bartelink A. K.M., Van Cromphaut S., Wilmer A., Van den Berghe G., Russell J. A.
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N Engl J Med 2007; 356:1178-1182, Mar 15, 2007. Correspondence

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