Tag Archives: Septic shock

Septic Shock; Reviewed by Dr. F. Perry Wilson, MD, MSCF on MedPage Today

Norepinephrine has long been the stable pressor agent for sepsis, but new data suggest that vasopressin might offer unique benefits. In this “150 Second Analysis”, MedPage Today clinical reviewer F. Perry Wilson discusses a study pitting the two drugs head-to-head, with an eye on renal failure as the primary outcome.

F. Perry Wilson, MD, MSCE, is an assistant professor of medicine at the Yale School of Medicine. He earned his BA from Harvard University, graduating with honors with a degree in biochemistry. He then attended Columbia College of Physicians and Surgeons in New York City. From there he moved to Philadelphia to complete his internal medicine residency and nephrology fellowship at the Hospital of the University of Pennsylvania. During his post graduate years, he also obtained a Master of Science in Clinical Epidemiology from the University of Pennsylvania. He is an accomplished author of many scientific articles and holds several NIH grants. He is a MedPage Today reviewer, and in addition to his video analyses, he authors a blog, The Methods Man. You can follow @methodsmanmd on Twitter.

Also visit the link to view the video:

http://www.medpagetoday.com/Nephrology/GeneralNephrology/59463

Sepsis – Number One Preventable Cause of Death Worldwide Discussed on C. diff. Spores and More With Guests Dr. Kissoon and Ray Schachter

 

Live Broadcast on Tuesday, April 5th

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Access this program Podcast on
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Sepsis – Number One Preventable Cause of Death Worldwide

 

On Tuesday, April 5th our guests Dr. Niranjan “Tex” Kissoon and Sepsis Survivor Ray Schachter discussed Sepsis – Number One Preventable Cause of Death Worldwide. 

In this episode Tex Kissoon, MD,a well-known physician from Canada, provided us with the insight into the global phenomenon of Sepsis. Sepsis affects more than 30 million lives per year yet it is almost unknown to the general public and is quite often misdiagnosed by medical professionals worldwide. The reasons of why that is with the “why” Sepsis is so deadly, and what you can do to increase Sepsis awareness– were discussed in  60 minutes. Dr. Kissoon was joined by Ray Schachter, a Sepsis survivor who now dedicates all of his available time raising awareness of Sepsis worldwide. Both guests are members of the Global Sepsis Alliance (GSA), which has established World Sepsis Day on September 13th every year to raise awareness for Sepsis worldwide.

About Our Guests:

Dr. Niranjan “Tex”  Kissoon, MD

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Dr. Kissoon is the Past President of the World Federation of Pediatric Critical and Intensive Care Societies, Vice-President, Medical Affairs at BC Children’s Hospital and Professor, Pediatric and Surgery (Emergency Medicine) Department of Pediatrics at the University of British Columbia in Vancouver, BC as well as he holds the University of British Columbia BC Children’s Hospital (UBC BCCH) Endowed Chair in Acute and Critical Care for Global Child Health.   Dr. Kissoon is the vice chair of the Global Sepsis Alliance, co-chair of World Sepsis Day and the  International Pediatric Sepsis Initiative.).  He has been involved in both advocacy and in promoting Canada-wide involvement in World Sepsis Day as part of a global initiative. He is also involved in promoting sepsis guidelines such that appropriate treatments are given even in areas where there are limited resources.

Dr. Kissoon was awarded a Distinguished Career Award by the American Academy of Pediatrics in 2013 for his contribution to the society and discipline as well as the prestigious Society of Critical Care Medicine’s (SCCM) Master of Critical Care Medicine award in 2015 in recognition of his tireless efforts and achievements as a prominent and distinguished leader of national and international stature.  He was also awarded the BNS Walia PGIMER Golden Jubilee Oration 2015 Award for major contribution to Pediatrics in India from the Postgraduate Institute Medical Education and Research. 

A Direct Quote From Our Guest and Sepsis Survivor;  Ray Schachter:

RayS

“I miraculously survived acute Sepsis in 1996 due to extensive medical intervention and have experienced the immediate and long-term consequences on me and my family.  I am the Chair of the Global Sepsis Alliance (GSA) Task Force whose goal is to have the UN mandate Sepsis as a World Health Day. Working with these very accomplished and committed people from GSA, many of whom are on the GSA Executive or Ambassadors, on this important project is a very special opportunity.”

About The Global Sepsis Alliance (GSA):
Sepsis is one of the most underestimated health risks. It affects more than 30 million people worldwide each year; for 6 to 8 million of them with a fatal outcome. Surviving patients often suffer for years from late complications.
This is all the more disturbing as sepsis incidence could be considerably reduced by some simple preventive measures such as vaccination and improved adherence to hygiene standards, early recognition and optimized treatment. The main danger of sepsis results from a lack of knowledge about it.
The founding members of the Global Sepsis Alliance (GSA) have recognized the need to elevate public, philanthropic and governmental awareness and understanding of sepsis and to accelerate collaboration among researchers, clinicians, associated working groups and those dedicated to supporting them. For this reason, they initiated the Global Sepsis Alliance in 2010. Together with supporting organizations from across the globe, we are united in one common goal:

The GSA  wants to ensure that:

  • The incidence of sepsis decreases globally by implementation of strategies to prevent sepsis.
  • Sepsis survival increases for children (including neonates) and adults in all countries through the promotion and adoption of early recognition systems and standardized emergency treatment
  • Public and professional understanding and awareness of sepsis improve
  • Access to appropriate rehabilitation services improve for all patients worldwide
  • The measurement of the global burden of sepsis and the impact of sepsis control and management interventions improve significantly

The GSA Current priorities:

  • Acknowledgement of a resolution on sepsis including official designation of World Sepsis Day (WSD) as one of the World Health Days by the World Health Assembly.
  • Recognition of sepsis in the Global Burden of Disease Report
  • Increase of public awareness and implementation of quality improvement initiatives

To learn more about the GSA please visit their websites:     http://global-sepsis-alliance.org

AND  World Sepsis Day:   http://www.world-sepsis-day.org

 

Our special thanks to GSA General Manager: Marvin Zick for his assistance in coordinating this important episode with the C. diff. Spores and More team.

 

C. diff. Spores and More,” Global Broadcasting Network – innovative and educational interactive healthcare talk radio program.

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C. diff. Infection (CDI) and Sepsis

What is Sepsis?

Sepsis is a potentially life-threatening complication of an infection. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammatory responses throughout the body. This inflammation can trigger a cascade of changes that can damage multiple organ systems, causing them to fail.  If sepsis progresses to septic shock, blood pressure drops dramatically, which may lead to death.

Anyone can develop sepsis, but it’s most common and most dangerous in older adults or those with weakened immune systems. Early treatment of sepsis, usually with antibiotics and large amounts of intravenous fluids, improves chances for survival.

Definition of Sepsis:  sep•sis (ˈsep-səs) n. Sometimes called blood poisoning, sepsis is the body’s often deadly response to infection.

Patients are given a diagnosis of sepsis when they develop clinical signs of infections or systemic inflammation; sepsis is not diagnosed based on the location of the infection or by the name of the causative micro-organism. Physicians draw from a list of signs and symptoms in order to make a diagnosis of sepsis, including abnormalities of body temperature, heart rate, respiratory rate, and white blood cell count. Sepsis may be diagnosed in a 72-year-old man with pneumonia,, fever, and a high white blood cell count, and in a 3-month-old with appendicitis, low body temperature, and a low white blood cell count.

What causes Sepsis?

Sepsis is a response to an infection. When you get an infection, your immune system releases chemicals into your blood to fight the infection. The chemicals sometimes cause body-wide inflammation, which can lead to blood clots and leaky blood vessels. This impairs blood flow, which damages the body’s organs by depriving them of nutrients and oxygen.

Different types of infections can lead to sepsis, including infections of the skin, lungs, urinary tract, abdomen (such as appendicitis), or other part of the body. Healthcare-associated infections (HAI’s), including pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and surgical site infections can sometimes lead to sepsis. MRSA infections of the skin and soft tissue can also lead to sepsis.

Sepsis infected blood cell

 TO DOWNLOAD A “SEPSIS AND C. difficile” Information guide, courtesy of Sepsis Alliance, CLICK ON THE FOLLOWING LINK:

http://www.sepsis.org/files/sig_sepsisandcdifficile.pdf

 

Who gets Sepsis?

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

How many people are diagnosed with Sepsis?

According to the CDC’s National Center for Health Statistics estimates that, based upon information collected for billing purposes, the number of times people were in the hospital with sepsis or septicemia (another word for sepsis) increased from 621,000 in the year 2000 to 1,141,000 in 2008.1  Between 28 and 50 percent of people who get sepsis die.2

The number of cases of sepsis each year has been going up in the United States.  This could be because of the following reasons:   the population is aging, people have more chronic illnesses, people are getting more invasive procedures, immunosuppressive drugs, chemotherapy, and organ transplants;  increasing antibiotic resistance,  increasing awareness and tracking of sepsis

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For Healthcare Professionals: Use this optional tool to screen patients for severe sepsis in the emergency department, on the medical/surgical floors, or in the ICU http://survivingsepsis.org/SiteCollectionDocuments/ScreeningTool.pdf

 

Recommendations: Special Considerations in Pediatrics*

 

 http://survivingsepsis.org/Guidelines/Documents/Pediatric%20table.pdf

 

4. Clostridium difficile colitis should be treated with enteral antibiotics if tolerated. Oral
vancomycin is preferred for severe disease (grade1A).
Sepsis Pocket Card for Healthcare Professionals:
Surviving Sepsis Campaign Bundle
Initial Resuscitation Bundle
To Be Completed in 3 hours:
1)Measure lactate level
2)Obtain cultures prior to administration of antibiotics
3)Administer broad spectrum antibiotics
4)Administer 30ml/kg crystalloid for hypotension or lactate greater
than or equal to 4mmol/kg
Septic Shock Bundle
To be Completed Within 6 Hours:
1)Apply vasopressors (for hypotension that does not respond to
initial fluid resuscitation) to maintain a mean arterial pressure
(MAP) greater than or equal to 65mmHg
2)In the event of persistent arterial hypotension despite volume
resuscitation (septic shock) or initial lactate greater than or equal
to 4mmol/L
a.Measure central venous pressure (CVP)*
b.Measure central venous oxygen saturation (ScvO2)*
3)Remeasure lactate if initial lactate was elevated*
*Targets for quantitative resuscitation included in the guidelines are CVP
greater than or equal to 8mmHg, ScvO2 greater than or equal to 70% and
normalization of lactate
> To print a pocket card please access the following link
References:
*International guidelines for management
of severe sepsis and septic shock: 2012.Crit Care Med. 2013; 41:580
*Mayclinic
*Survivingsepsis.org
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
* Sepsis Alliance  http://www.sepsisalliance.org
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