These observations highlight the need for effective intervention methods selleck bio for this highly lethal syndrome. Moreover, it seems that there is a need for further studies or for a revisit to the manner in which studies are conducted and their results are implemented in the real world [11].Resuscitation is the major component of initial burn care and must be managed to restore and preserve organ function. Prevention of inadequate perfusion, due to burn fluid loss, remains the top priority for initial management. Advances in fluid management have led to a marked decrease in fatal burn shock and its related complications. Williams and colleagues reported that shock accounted for 8% of their deaths [1]. The obvious challenge concerning resuscitation is to provide enough fluid to maintain perfusion without causing overload [3,12,13].

Without effective and rapid intervention, hypovolemia will develop. A delay in fluid resuscitation beyond 2 hours of the burn injury complicates resuscitation and increases mortality [14]. The consequences of excessive resuscitation and fluid overload are as deleterious as those of under-resuscitation: pulmonary edema, myocardial edema, conversion of superficial into deep burns, the need for fasciotomies and abdominal compartment syndrome. A recent approach has led to conversion of a formula-driven process to a more critical care approach using more physiologic endpoints such as urinary output and other measurements, so the trend in burn resuscitation is shifting the focus from fluid formulas to adequate endpoint monitoring, edema control and adjuvant therapies [12,15,16].

On some level, a lot of burn deaths may be preventable with better airway management and more precise and adequate volume management. Sepsis due to multidrug-resistant organisms, however, will continue to impede efforts to increase survival. We have to develop strategies to fight these organisms that go beyond the surgical and clinical techniques that are already implemented. Moreover there will be a need for further studies that are facing the problems concerning respiratory and multiorgan failure.Competing interestsThe author declares that they have no competing interests.NotesSee related research by Williams et al., http://ccforum.com/content/13/6/R183
Sepsis is a leading cause of death in critically ill patients despite the use of modern antibiotics and resuscitation therapies [1].

The septic response is an extremely complex chain of events involving inflammatory and anti-inflammatory processes, humoral and cellular reactions and circulatory abnormalities [2,3]. The Dacomitinib diagnosis of sepsis and evaluation of its severity is complicated by the highly variable and non-specific nature of the signs and symptoms of sepsis [4]. However, the early diagnosis and stratification of the severity of sepsis is very important, increasing the possibility of starting timely and specific treatment [5,6].