R.Phillip Dellinger,MD, FCCM*,Cooper University Hospital, Cooper Medical School of Rowan University, Head Division of Critical Care Medicine, Department of Medicine
Christa A. Schorr, RN, MSN, FCCM*
Sepsis is a serious and sometimes deadly medical condition caused by the presence of an infection and a whole-body inflammatory response to the toxins being released into the bloodstream as a result of that infection. This process can cause essential body organs, like the lungs, liver, kidney, or heart, to fail — with the risk for death.
Worldwide 18 million cases of severe sepsis are reported each year, including 750,000 cases in the United States. More than 200,000 Americans die each year despite the $17 billion we spend annually treating this illness. Sepsis is not a selective illness. It can affect anyone, regardless of age, race, social class or economic status.
How does one know when to contact a healthcare provider because of suspected sepsis? If you or a loved one are experiencing symptoms such as a fast heart beat, rapid or difficult breathing, not acting or thinking clearly, or feel lightheaded or dizzy (as a sign of low blood pressure), you should seek medical attention. Family members should be alert and watch for these signs when infection is suspected. Being alert to these signs is equally important when a patient is admitted to the hospital. Failure of a major organ with no clear cause is a red flag to ask questions. The family can support their loved one by voicing concerns to the healthcare team. For example, “Could this be an infection?” and “Are antibiotics required?” are reasonable questions to ask. This is particularly true if there is a fever, high white blood cell count or other signs of infection. Even if the cause of the infection is unknown, asking questions may prompt an added examination. Remember, early discovery of sepsis and delivery of antibiotics may be life-saving.
Why do some people get severe life-threatening infections, and others do not? The elderly, those with weakened immune systems and those who have had recent surgery are at higher risk. Sometimes sepsis affects previously healthy people due to bad luck or genetic factors.
Avoiding the life threatening stage of sepsis may include other treatments along with antibiotics. Two other important keys to the successful treatment of severe sepsis are (1) support of vital organs, when needed. Treatment may include respiratory, kidney, and blood pressure support and (2) controlling the source of infection. Examples of source control are draining of a puss pocket or removal of an infected device, like an artificial knee.
Please know that severe sepsis is common. It is a potentially life threatening illness and can be curable when detected and treated early.
* Editor’s note – Ms. Schorr and Dr. Dellinger are members of the core leadership team of the Surviving Sepsis Campaign which has enrolled over 300 hospitals in over 30 countries, all committed to use current best practice in the management of severe sepsis to improve survival in this potentially devastating disease. To date, over 30,000 patients have been entered into a database that analyzes healthcare practitioner performance in caring for these patients in hope of learning how to improve care. The software for the database was developed at Cooper University Hospital in collaboration with the Institute for Healthcare Improvement.