What comes after the Early Goal Directed Therapy for sepsis era?
The idea of sepsis was introduced in the literature in the 4th century BCE by the ancient Greek Hippocrates when animal and plant decomposition (σηψις, rot) was reported. In the 11th century, Avicenna described the process of acute inflammation and purulence formation, a “blood rot”, and he included body temperature, heart rate, and the state of body fluids in his description (1). However, the word “sepsis” was not used until the 19th century. Over the past 30 years, the need to understand the underlying pathophysiological process and to identify better clinical criteria for early detection of sepsis has rapidly evolved because of the increasing number of patients with sepsis receiving advanced organ support systems, including mechanical ventilation, renal replacement therapy, and extracorporeal membrane oxygenation, has taxed health care systems (2,3). Furthermore, our awareness of the morbidity, mortality, and cost associated with this condition has increased.