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To the Editor: Severe sepsis: defined by inflammation (aberrant temperature and white blood cell count, tachypnea and tachycardia); suspicion of infection; and evolving organ dysfunction, is associated with an incidence, mortality and cost similar to acute coronary syndromes. 1 However, sepsis has not received similar recognition or funding. Evidence suggests “golden hours” during which early and aggressive therapy can prevent progression to intractable organ failure. 2 Guidelines now provide evidence-based strategies to expedite a continuum of care from the emergency department, to the ward, to the ICU. 3 As such, the next decade holds great potential. Conceptually this is similar to the “chain-of-survival” recommended for cardiac disease. 4 Early goal-directed therapy, early antibiotic administration, tight glycemic control, low-dose corticosteroids, consideration of recombinant protein C, and consideration of early transfer to ICU are all likely to improve mortality. 3

Sepsis therapy in the next decade: seamless care from emergency to the ICU