Weil MH, Afifi AA. Experimental and clinical studies on lactate and pyruvate as indicators of the severity of acute circulatory failure (shock). Circulation. 1970;41:989–1001.

Article abstract not available.

Alberti C, Brun-Buisson C, Chevret S, et al. Systemic inflammatory response and progression to severe sepsis in critically ill infected patients. American Journal of Respiratory and Critical Care Medicine. Nov 2004.

This article describes a study which tried to examine the incidence of and risk factors for worsening sepsis in infected patients.  The study concludes that about one quarter of patients with infection/sepsis have their condition worsen to severe sepsis or shock.

Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Critical Care Medicine. 2003;31(4):1250-1256.

In 1991, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) convened a "Consensus Conference," the goals of which were "to provide a conceptual and a practical framework to define the systemic inflammatory response to infection, which is a progressive injurious process that falls under the generalized term 'sepsis' and includes sepsis-associated organ dysfunction as well." The general definitions introduced as a result of that conference have been widely used in practice and have served as the foundation for inclusion criteria for numerous clinical trials of therapeutic interventions. This document reflects a process whereby a group of experts and opinion leaders revisited the 1992 sepsis guidelines and found that, apart from expanding the list of signs and symptoms of sepsis to reflect clinical bedside experience, no evidence exists to support a change to the definitions.

Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. New England Journal of Medicine. 2001;345(19):1368-1377.

A randomized controlled, single institution trial demonstrating reduction in mortality due to severe sepsis by pursuing early-goal directed therapies.

Iregui M, Ward S, Sherman G, Fraser VJ, Kollef MH. Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia. Chest Journal. Jul 2002;122(1):262-268.

Article which describes a study to determine the influence of initially delayed appropriate antibiotic treatment (IDAAT) on the outcomes of patients with ventilator-associated pneumonia (VAP).

Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Critical Care Medicine. Jul 2001;29(7):1303-1310.

Article describing a study to determine the incidence, cost, and outcome of severe sepsis in the United States. 

Friedman G, Silva E, Vincent JL. Has the mortality of septic shock changed with time. Critical Care Medicine. Dec 1998;26(12):2078-2086.

The authors of this article performed a systematic review of literature to test the mortality of septic shock over time.  The research demonstrated a slight reduction in the percent of mortality. 

Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. New England Journal of Medicine. 2001;344(10):699–709.

A randomized, double-blind, placebo-controlled, multicenter trial showing that treatment with drotrecogin alfa activated significantly reduces mortality in patients with severe sepsis and may be associated with an increased risk of bleeding.

Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. New England Journal of Medicine. 2000;342(18):1301–1308.

A multi-center, randomized controlled trial comparing a low tidal volume ventilation strategy to traditional ventilation strategies. The authors concluded that in patients with acute lung injury and ARDS, mechanical ventilation with a lower tidal volume resulted in decreased mortality and increased the number of days without ventilator use.

Finney SJ, Zekveld C, Elia A, Evans TW. Glucose control and mortality in critically ill patients. Journal of the American Medical Association. 2003;290(15):2041-2047.

Single-center, prospective, observational study showing that increased insulin administration is positively associated with death in the ICU regardless of the prevailing blood glucose level. Thus, control of glucose levels rather than of absolute levels of exogenous insulin appear to account for the mortality benefit associated with intensive insulin therapy.