Surviving Sepsis

Sepsis. It is a medical term we often hear of or hear about. But what do we really know about it? A lot of misconception and misunderstanding surrounds it, leading to devastating consequences.

Our immune system helps protect our bodies every day. It responds to everything that our body encounters, including infection and injury. Sepsis is our body’s overwhelming response to these insults. It is a series of events that happens when our bodies get infected, and our immune system is unable to control it. Sepsis very commonly is caused by bacterial infections but can also present as viral or fungal infections. Non-infectious causes can also trigger the immune system, giving the same effect. In some cases, the cause can’t be determined. The response is unpredictable, and often is a spectrum. It is life-threatening and needs emergent care, as without intervention, sepsis can quickly lead to loss of life and limb.

According to the Centers for Disease Control and Prevention (CDC), 1.7 million adults in the U..S develop sepsis. Worldwide, 20% of all global deaths are sepsis-related, as reported by the World Health Organization (WHO) from published data in 2020. Death rates depend on where the patient develops sepsis. Rates are up to 25% from sepsis in the hospital setting, and up to 75% from sepsis at home!

Several factors can put you at risk for developing sepsis. These include extremes of age (65 years and older, and children less than one), pregnancy and post-partum period, conditions and medications that can weaken the immune system, and chronic medical conditions including diabetes, cancer, and chronic lung and kidney diseases. Anyone who was recently admitted to the hospital for a serious illness, or had recent surgery are also at risk. Even people who have survived sepsis are at a higher risk of developing a repeat episode. It is still unclear the exact mechanisms that can predict who will survive or who will succumb to this condition. But it is well-known that early diagnosis and treatment is of utmost importance.

The CDC has listed steps to “get ahead” of sepsis. First is to PREVENT INFECTIONS. Good control of chronic medical conditions, especially diabetes, as well as receiving the recommended vaccinations, can help reduce the incidence and severity of sepsis. Eating a healthy diet is also key. Breastfeeding for newborns reduces the risk of infection, as protective antibodies are passed on from mother to infant in the first few months of life.

Second, PRACTICE GOOD HYGIENE. Hand washing is a simple but effective way to prevent infection. Avoid touching your face as much as possible. Pay attention to wounds and cuts and seek medical help promptly if home measures do not seem to improve skin infections. Sepsis is not contagious, but you can develop infections that can lead to sepsis.

Third, KNOW THE SIGNS AND SYMPTOMS OF SEPSIS. These include high heart rate or weak pulse; fever, shivering or feeling very cold; confusion or disorientation; shortness of breath; extreme pain or discomfort; and clammy or sweaty skin. For infants, fewer ?wet diapers and feeding difficulties can be signs of worsening infection. Convulsions, fast breathing and lethargy are also seen in children.

Lastly, ACT FAST. When in doubt if infection is leading to sepsis, or if your condition is not improving or is getting worse, do not delay in getting immediate evaluation by healthcare professionals. Even patients who have already been diagnosed with uncomplicated infections, like urinary tract infections or community-acquired pneumonia, and have been put on oral antibiotics by their primary care providers, can get worse and may need more aggressive treatment.

Once in the medical setting, healthcare professionals will quickly evaluate for evidence of response to infection. They will also evaluate for evidence of organ dysfunction and failure, which can occur when blood pressure drops to an alarming level leading to poor blood supply to essential organs depriving it of nutrients and oxygen. This is known as septic shock and is a harbinger of poor outcome.

Although there is no specific treatment protocol for sepsis, guidelines are in place to help manage sepsis. Diagnostic work-up would include blood tests, like blood cultures and lactate levels, and imaging studies, like x-rays and CT scans. Part of the management is fluid resuscitation, antibiotics, medications that will support the blood pressure, and giving oxygen as needed. Surgery at times is required if the infection has caused severe tissue damage or have spread from the original organ that was infected. The Surviving Sepsis Campaign is a joint collaboration of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) committed to reducing mortality and morbidity from sepsis and septic shock worldwide. They have made tremendous strides since their inception in 2002.

September is Sepsis Awareness Month. Increasing our knowledge about this condition is the first step for us as a community, to protect ourselves from the devastating effects of sepsis if left untreated. It helps to be vigilant and proactive. Let us all be advocates and promoters of good health and save lives.

Dr. Katrina Victoria is a Physician who specializes in infectious disease. She will be joining Western Wisconsin Health as a full-time physician in September. If you, or someone you know, are experiencing any of the above-listed conditions, seek urgent medical care. If you are concerned that you are suffering from an infectious disease or have a wound that required treatment, call us at 715-684-1111 to schedule an appointment with Dr. Victoria.

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“Surviving Sepsis Campaign”. Society of Critical Care Medicine. cited 2024 Aug 27. Available from: https://www.sccm.org/SurvivingSepsisCampaign/Home