Sepsis Facts

Sepsis Facts

Sepsis is an illness that can happen in response to an infection that affects all parts of the body and can quickly become life-threatening.
In severe sepsis, one or more organ functions fail. In the worst cases, sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. Once this happens, multiple organs may quickly fail. At this stage, sepsis becomes very difficult to treat even with advanced care. Between 28 and 50 percent of people who get severe sepsis die. But even among suvivors, patients who develop sepsis have an increased risk of complications and face higher healthcare costs, longer treatment, and more disability.

Causes
Sepsis is an abnormal response to an infection. When you get an infection, your immune system releases chemicals into your blood to fight the infection. In sepsis, the production of these chemicals becomes unregulated, causing body-wide inflammation, which can lead to the formation of blood clots in small vessels, leaky blood vessels, loss of vessel tone, and even direct organ damage. The hallmarks of generalized inflammation include increases in heart rate, breathing rate and temperature, as well as an increase in the white blood cell count.

Different types of infections can lead to sepsis, including infections of the skin, lungs, urinary tract, abdomen (such as appendicitis), or other parts of the body. Sepsis usually comes from bacteria, but viruses and fungi can also cause the sepsis response. In modern times, healthcare-associated infections, including pneumonias, central line-associated bloodstream infections, catheter-associated urinary tract infections, and surgical site infections can lead to sepsis.

Risk Factors

Anyone can get sepsis, but the risk is higher in:
• people with weakened immune systems
• infants and children
• elderly people
• people with chronic illnesses, such as diabetes, AIDS, cancer, and kidney or liver disease
• people suffering from a severe burn or physical trauma

Symptoms
• Fever and chills
• Rapid breathing
• Rapid heart rate
• An abnormally low blood pressure
• Rash
• Confusion or disorientation

Because fever, rapid breathing and rapid pulse rates occur in less serious conditions like the common flu, sepsis is sometimes hard to diagnose in its early stages.

Diagnosis

The diagnosis of sepsis depends on the suspicion of an infection, tied with signs of generalized inflammation and worsening organ function. Doctors normally request for cultures of blood, urine, sputum or other samples depending on the suspected source of infection. A blood count will reveal whether white cells are increased. Blood chemistry and other tests are used to define if organ function is beginning to fail.

Treatment

People with severe sepsis are usually treated in the hospital’s intensive care unit. In general, doctors try to identify and treat the infection, while sustaining the vital organs.

How can The Medical City help you?

Since 2007, a special program called the Sepsis Alert has been in place in TMC to quickly identify and differentially treat patients that may be suffering from severe sepsis. The Sepsis Alert can be initiated by any physician, whether from the ER, the nursing units, or even by the Code Teams.
Through the Sepsis Alert, severe sepsis is rightly treated as an emergency as it is as serious as a heart attack. Infectious Disease (ID) and Critical Care (CC) specialists are consulted automatically and bundled tests are performed to find the source of infection and to define any organ failures. ID doctors ensure the appropriate antibiotic and source control strategies. CC doctors, on the other hand, coordinate the multidisciplinary response up to and including life support.
TMC’s Sepsis Alert program has been proven to decrease the mortality of patients with severe sepsis by about 20% and until now is the only program of its kind in the Philippines.

The Medical City also has numerous programs through the Hospital Infection Control and Epidemiology Center (HICEC) to prevent the occurrence of hospital-acquired infections such as pneumonia, catheter-related infections, and surgical site infections.

References:
1. NCHS Data Brief No. 62 June 2011 - Inpatient Care for Septicemia or Sepsis: A Challenge for Patients and Hospitals
2. Wood KA, Angus DC. Pharmacoeconomic implications of new therapies in sepsis. PharmacoEconomics. 2004; 22(14):895-906.