New Study Aims to Stop Sepsis in its Tracks
One of the major challenges is to recognize sepsis when it starts. That's because in its early stages, it is often mistaken for a milder infection or other problems, said Angus. "A person may arrive with what looks like a simple case of pneumonia, and the emergency department team starts antibiotics and believes things will go well. Only when the blood pressure drops or is no longer responsive to intravenous fluids does the team realize it is suddenly behind the eight ball. By then, the patient is quickly spiraling into multisystem organ failure. Starting resuscitation at this point may already be too late."

To test ways of managing the disease during the first six hours after diagnosis, the consortium will train teams of doctors, nurses, and other health professionals. The sepsis teams will focus their attention on one patient at a time and will follow a scripted protocol to stabilize, diagnose, and treat sepsis.

The protocol includes a sequence of resuscitation methods to deliver fluids, restore blood pressure, and monitor cardiovascular function and other organ activity. It was developed several years ago by Emmanuel Rivers, a researcher and physician at Henry Ford Hospital in Detroit, where it dramatically increased survival rates. But to implement this approach across the entire country is a daunting task. As a first step, the consortium aims to find out whether the protocol will have similar success at multiple hospitals across the nation.

Following a year-long period of establishing and training sepsis teams, the consortium plans to treat early severe sepsis in nearly 2,000 patients, enrolling patients over a two- to three-year period. It will then follow all the patients for a full year after their recovery to detect any long-term differences in health and mortality rates.

The scientists will also measure blood levels of certain factors that are thought to cause severe sepsis. By examining how these levels change over time and with the different interventions, the scientists will discover whether the factors can serve as molecular markers to help track organ function and recovery progress in patients. This molecular approach may also shed light on new ways to understand and treat sepsis.

Finally, consortium researchers will study the cost-effectiveness and logistics of establishing such protocols in emergency departments around the country. The scientists aim to develop a blueprint, complete with lists of tips and traps, to help hospitals adopt standardized methods for evaluating and treating early sepsis patients.

Writer: Susan Gaidos

...back