In this issue of THE JOURNAL, Hotchkiss and Karl1 review the somewhat paradoxical literature regarding changes in cellular metabolism that occur in sepsis. Their study begins with an apt quotation stating that, the more you look into a complicated problem, the more complicated the problem becomes. This is a virtual understatement when applied to our knowledge of sepsis.2 This study is one of scientific interest— one that could turn out to be of great importance in our understanding of the pathophysiology of sepsis and in finding new treatments for the syndrome. When you look at a problem from a direction that challenges conventional wisdom, you may also be getting a view that helps you to finally resolve the problem.
See also p 1503.
The authors advance a provocative theory that challenges the traditional views regarding the occurrence of hypoxia and elevated blood lactate levels in patients with sepsis.
Bone RC. Abnormal Cellular Metabolism in SepsisA New Interpretation. JAMA. 1992;267(11):1518-1519. doi:10.1001/jama.1992.03480110094041