In the subsequent decade, much collaboration between expert groups helped form definitions for a range of critical diseases, including sepsis. In 1991, a consensus conference of the American College of Chest Physicians and the Society of Critical Care Medicine convened to establish definitions for sepsis and organ failure. This joint venture was led by a committee of eight experts who co-opted many other colleagues from North America. Some 2 years earlier, Balk and Bone2 tackled the thorny issue of “the septic syndrome: definition and clinical implications.” Indeed, several pharmaceutical clinical trials around that time were bearing scientific data that would help underpin the new consensus. The 1991 recommendations focused on defining specific terms such as sepsis, infection, bacteremia, septicemia, severe sepsis, septic shock, and multiple organ dysfunction syndrome.3 The authors examined severity scoring systems, concluding that problems still remained in this area, and they highlighted some of the issues relating to evaluation of innovative therapies for managing sepsis in the early 1990s. Recently, these consensus statements have been superseded, but they clearly formed the pathway and strategy to ensuring progress was made in a very complex field.