• Andrew W Artenstein, Thomas L Higgins, and Steven M Opal.
• 1Department of Medicine, Baystate Health and Tufts University School of Medicine, Springfield, MA. 2Division of Infectious Diseases, Memorial Hospital of Rhode Island and the Alpert Medical School of Brown University, Providence, RI.
• Crit. Care Med.. 2013 Dec 1;41(12):2770-2.

HypothesisThe therapeutic approach to sepsis is following an evolutionary process of scientific discovery as articulated in the landmark work by Kuhn, The Structure of Scientific Revolutions, first published 50 years ago.BackgroundIncremental advances, beginning with the introduction of antimicrobials and most recently highlighted by revised, evidence-based guidelines for the management of sepsis, have been accompanied by episodic paradigm shifts. Although some of these have shown success, there are numerous, noteworthy failures, largely involving immune- and coagulation-based therapeutic strategies.ConclusionA sustained paradigm shift in the approach to treating sepsis has yet to emerge, but recent data suggest that an open-minded posture informed by novel pathobiologic findings may eventually bear fruit.

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