Sepsis, SIRS and MODS

Sepsis, a systemic inflammatory process triggered by infection, is the commonest mode of death in modern surgical practice. Sepsis exists as a spectrum of severity from the Systemic Inflammatory Response Syndrome (SIRS) through to Multiple Organ Dysfunction Syndrome (MODS). The surgeon must be able to recognize patients within this spectrum rapidly because early identification and intervention is the key to reducing mortality. Rapid, accurate assessment and management are facilitated by using a structured approach such as that described in the Care of the Critically-Ill Surgical Patient (CCrISP) programme. Control of the source of sepsis is fundamental to success and this should be led by senior surgeons. Key steps and timelines are described in the evidence-based ‘care bundles’ of the Surviving Sepsis Campaign.