Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock.

Organ system dysfunction is a common adverse sequelae of severe sepsis and septic shock and has been reported to be the most common cause of death in the noncoronary intensive care unit. The pathophysiology of the development of multiple organ system dysfunction is likely multifactoral and may take several different pathways. The frequency of specific organ system involvement is dependent on the definition used to describe the organ dysfunction. The presence of organ dysfunction has great clinical impact on the underlying disease process, can prolong the hospital stay, increase the cost of care, and has been associated with an increase in mortality rate. At present, there is no recognized specific treatment for established organ failure, this primary attention has been directed toward prevention.