Some relatively new techniques have shown a lot of promise in the
treatment of severe sepsis. For example, Early Goal Directed Therapy
(EGDT), which involves intense monitoring of oxygen delivery to the
patient, can resuscitate patients and reduce the risk of mortality in
people with dysfunctions of the heart or other organs. The benefit of these newer methods decreases, however, if there is any
delay in beginning them, which makes it essential for doctors to
determine which patients are at the highest risk and for patients and
families to be alert to the symptoms.
WHY IS SEPSIS SO DANGEROUS?
A person can develop sepsis when the body -- in
particular, the bloodstream -- is overwhelmed with bacteria. The
infection can begin anywhere in the body, but common places are the intestines, kidneys, lungs (as in pneumonia), or the linings around the brain (as in meningitis).
If a patient is hospitalized for any reason, sepsis can develop from an IV line or at a surgical incision if he or she has had surgery.
Symptoms of severe infection typically include chills, fever,
confusion, rash, and shaking. The most dangerous symptom of sepsis is a
rapid drop in blood pressure, which can cause a patient to go into
shock, which is life-threatening since the organs, including the brain,
are deprived of oxygen. Treatment involves giving antibiotics through
an IV, and administering fluids, oxygen, and medications to bring blood
pressure back up. Sometimes a breathing machine or dialysis may be
needed if the lungs or kidneys are affected.
DETERMINING A PERSON'S RISK EARLY ON SAVES TIME, MONEY, AND LIVES
Because of the seriousness of sepsis and the
possibility of shock, it is critical for doctors to determine each
patient's risk level, so that he or she may be treated quickly and
appropriately. More than 50 percent of patients with severe sepsis receive
some part of their care in an intensive care unit (ICU), and sepsis is
the most common cause of ICU admissions (other than surgery) in the
Treating severe sepsis contributes significantly to
the overcrowding of ICUs, and adds to the more than $16 billion annual
cost of caring for this syndrome in the U.S. As our population ages, the number of severe sepsis cases will inevitably increase.
Accurate methods to determine a person's risk could focus our limited
health care dollars on seriously ill patients who are most likely to
benefit, and at the same time decrease the use of invasive procedures on
patients who have lower risk. Here, we'll outline some of the newer
techniques that doctors use to figure out who's at greater risk for
sepsis and who is not.
Sepsis can affect one or many organs of the body, depending on the
extent of the infection. Doctors determine whether organs are failing
using basic clinical evidence that is fairly clear-cut, and doing so can
tell them who is at risk for death in the short term. However, patients with severe sepsis can range from having several
failing organs to more mild organ "malfunctions." Therefore, there are
limits to what organ function -- or organ failing -- can tell us about the
health status of the patient in question. For this reason, doctors
have to use additional techniques that help them flesh out the picture
when a patient develops sepsis.