Sepsis occurs when chemicals released in the bloodstream to fight an infection trigger inflammation throughout the body. This can cause a cascade of changes that damage multiple organ systems, leading them to fail, sometimes even resulting in death. Symptoms include fever, difficulty breathing, low blood pressure, fast heart rate and mental confusion. Treatment includes antibiotics and intravenous fluids. Citations are important for a journal to get impact factor. Impact factor is a measure reflecting the average number of citations to recent articles published in the journal. The impact of the journal is influenced by impact factor, the journals with high impact factor are considered more important than those with lower ones.