Management of severe sepsis and septic shock: challenges and recommendations.

Sepsis and related aspects has become an area of active and intense research, leading to important advances for an early diagnosis and appropriate management useful to improve patient outcome. The septic response is an extremely complex cascade of events, including proinflammatory, anti-inflammatory, humoral, cellular, and circulatory involvement. The pathophysiology of this syndrome, its various and changing clinical aspects, and the vast variety of therapeutic options available, not always of well-proved efficacy, make its management a goal difficult to achieve.