SummaryIn recent times our understanding of metabolism at the biochemical and subcellular level has increased. It is now apparent that an understanding of the causes and mechanism of the inflammatory response to sepsis is vital to the management of this condition. The systemic inflammatory response in sepsis disrupts the normal homeostatic processes and can progress to multiple organ failure and death.Increased metabolic rate as a result of sepsis causes a characteristic hypocaloric and hypoproteinaemic malnutrition. Specific amino acids are necessary for the synthesis of proteins and vasoactive peptides and for the functioning of macrophages and leucocytes. In addition, arginine, glutamine, omega-6-fatty-acids and nucleotides are required for adequate immune function. Thus, adequate nutritional support can greatly influence outcome in patients with sepsis.Since the adverse sequelae of sepsis result from the neuroendocrine inflammatory response, nonsteroidal anti-inflammatory drugs have therapeutic potential in this condition. In the future, monoclonal antibodies to bacterial endotoxins are expected to limit the inflammatory response to endotoxins produced by Gram-negative bacteria.

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