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The clinical syndrome sepsis and septic shock comprise of disorders which are increasingly common, potentially lethal, yet not clearly understood clinical syndromes. The rise in the incidence is well documented and thought to be ascribed to the ageing of the population, the prevalence of immune compromised patients and implantable medical devices and the progressive increase in antimicrobial resistance amongst common bacterial pathogens. Septic shock is a manifestation of sepsis and recent evidence suggests that the endothelial surface does not have a passive role in systemic inflammatory states such as septic shock. In fact, endothelial cells are in dynamic equilibrium with a myriad of inflammatory mediators and elements of the innate immune and coagulation systems to orchestrate the host responses in sepsis. There is considerable progress in the understanding of the biochemical and metabolic disturbances occuring during this patho-physiological state and henceforth reduction in mortality rates. This article illustrates the recent advances in the management and treatment of this serious anomaly.
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