Chaotic sepsis and the magic bullet

Abstract

All physiological systems have complex interactions-both intrinsic and with external systems. Sepsis is an archetypal example of a self-regulating complex system, with multiple cascading non-linear interactions and feedbacks, acting in series and in parallel, to form a "scale-free" network. The process of sepsis may be modelled in terms of complexity theory as an iterative progression from a stable, homeostatic pathway or attractor to an unstable attractor of immunological dissonance and death. Given the convolutions of the septic attractor, complexity theory neatly explains why so many "magic bullet" therapies for sepsis have failed when given alone, since reductionist approaches which test individual treatments one at a time are highly unlikely to be effective in isolation. A new methodology of synchronously testing multiple therapies needs to be developed.