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1.no, it cannot be as a protective mechanism - sepsis is very bad - this is probably what you mean, but it should be explicit2.not really, it is a dysregulated host response - often , but not only immunosppressive4.can be more than functional if apoptosis etc - it is organ dysfcuction, regardless of the mechanisms5.no, severe sepsis was sepsis (with SIRS) + organ dysfunction - the term sepsis includes organ dysfunction, but sepsis is not what was described before 6.we will continue to speak about multiple organ failure in our every day language, this is OK7.but you argued above that we should abandon SIRS - SIRS is primarily a sign of infection (fever, associated tachycardia, altered WBC) - this is usually how we identify an infection8.we proposed PIRO at another consensus conference in Toronto 9.it is quite simple, but it is not part of the definition, it is just to put some order in our thoughts10.the MODS score is now replaced by the SOFA score (which derived from it)
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