[Severe sepsis and septic shock: everything done, everything to be done].

In the last decade severe sepsis and septic shock have been the subject of intense study, and the expanding body of scientific evidence has afforded better and more in-depth understanding of this pathology. A simple PubMed search of these terms shows that in the period between 1001 and 2011, the number of published articles doubled that of the preceding decade. Severe sepsis is characterized by high mortality, particularly when associated to shock. Moreover, several epidemiological studies have reported an increase in the incidence of severe sepsis. Please tag and link citations/tables/figures throughout the text accordingly. In Spain, the incidence of severe sepsis is 104 cases per 100,000 inhabitants/year, while the incidence of septic shock is 31 cases per 100,000 inhabitants/year. The Surviving Sepsis Campaign (SSC) was launched in 2002, as an important effort to understand and adequately treat severe sepsis and septic shock. This is an international initiative, sustained by different scientific societies dedicated to critical care throughout the world, with the purpose of reducing mortality attributable to this pathology through the development and implementation of clinical practice guides. One of the most relevant contributions of the SSC has been the ‘‘time-dependency’’ concept, i.e., in the same way as in other acute disease conditions, the lesser the time elapsed from the onset of damage to the adoption of treatment measures, the lesser the incidence of organ dysfunction and thus also of patient mortality. An illustrative way of referring to this would be: ‘‘Time is tissue’’. Accordingly, the SSC guide includes the recommendation to provide treatment