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Have Doctors Found a Cure for Sepsis?

Have Doctors Found a Cure for Sepsis?

According to the Centers for Disease Control and Prevention, between one and three million people in the U.S. are diagnosed with sepsis each year and between 15 and 30 percent of those patients die.

It’s quite difficult not to be hopeful concerning news of a possible effective and successful treatment for sepsis, a condition that leads to multiple organ failure and kills more people in the hospital than any other disease. A recent announcement published by the journal, Chest, claims a doctor from Norfolk, Virginia reported amazing results when treating patients facing a risk of sudden death due to sepsis.

But, before we get to the good news, let’s get a better understanding of this deadly condition.

What is Sepsis? What Causes It?

Sepsis is a complication caused by the body’s overwhelming and life-threatening response to an infection, which can lead to tissue damage, organ failure, and death.

Many types of infection can lead to sepsis. In simple terms, an infection occurs when germs multiply, enter a person’s body and multiply, causing illness, and organ and tissue damage. Certain infections and germs are more likely to lead to sepsis: Infections from a simple bug bite or a hangnail or an infection of the lungs (pneumonia), urinary tract (kidney), skin, or gut. Staphylococcus aureus (staph), Escherichia coli (E. coli), and some types of Streptococcus (strep) are common germs that can cause the condition.

Many doctors view sepsis as a three-stage syndrome, starting with sepsis and progressing through severe sepsis to septic shock. The goal is to treat sepsis during its early stage—before it becomes more dangerous.

Who’s at Risk?

A Centers for Disease Control and Prevention (CDC) report released last year aimed to identify those most likely to contract sepsis. The report showed that that for nearly 80 percent of patients, sepsis begins outside the hospital. Interestingly, it also found that seven in 10 patients with sepsis had recently used health care services or had chronic diseases requiring frequent medical care.

Those at the highest risk of developing sepsis include the very young and the very old (infants and seniors), as well as people with chronic or serious illnesses, such as diabetes and cancer, and those who have an impaired immune system.

A specific diagnostic test for sepsis does not exist, but doctors diagnose it based on a combination of symptoms and biomarkers found in lab tests. Getting to a hospital early is paramount, because the longer you go without treatment, the more likely it is the infection will become fatal.

Learn the Signs

There is no single sign or symptom of sepsis. It’s, instead, a combination of symptoms. Since sepsis is the result of an infection, symptoms can include infection signs (diarrhea, vomiting, sore throat, etc.), as well as any of the following symptoms:

  • Shivering, fever, or extreme cold;
  • Extreme pain or discomfort;
  • Clammy or sweaty skin;
  • Confusion or disorientation;
  • Shortness of breath; and
  • A high heart rate.

If any of the following symptoms are observed, sepsis has reached a late stage and quick action is critical:

  • Dizziness or feelings of faintness;
  • Confusion or a drop in alertness, or any other unusual change in mental state, including a feeling of doom or a real fear of death;
  • Slurred speech;
  • Diarrhea, nausea, or vomiting;
  • Severe muscle pain and extreme general discomfort;
  • Difficulty breathing or shortness of breath;
  • Low urine output (not needing to urinate for a whole day, for example);
  • Skin that is cold, clammy, and pale, or discolored or mottled;
  • Skin that is cool and pale at the extremities, signaling poor blood supply; or
  • Loss of consciousness.

Is a Breakthrough in Treatment on the Horizon?

Typically, treatment for sepsis involves more than one type of antibiotic based on the type of infection causing the underlying illness. But antibiotics alone won’t treat sepsis; fluids are also needed. The body needs extra fluids to help keep the blood pressure from dropping dangerously low, sending the patient into shock.

The amazing news coming only days ago is that a new, seemingly successful treatment for sepsis may have been discovered.

As reported by National Public Radio (NPR): In January of 2016, Dr. Paul Marik was running the intensive care unit at Sentara Norfolk General Hospital when he encountered a 48-year-old woman with a severe case of sepsis.

“Her kidneys weren’t working. Her lungs weren’t working. She was going to die,” he said. “In a situation like this, you start thinking out of the box.”

Marik had recently read a study by researchers at Virginia Commonwealth University in Richmond. Dr. Berry Fowler and his colleagues had shown moderate success in treating people who had sepsis with intravenous vitamin C.

Marik decided to give it a try. He added in a low dose of corticosteroids, which are sometimes used to treat sepsis, along with a bit of another vitamin, thiamine. His desperately ill patient got an infusion of this mixture.

“I was expecting the next morning when I came to work she would be dead,” Marik said. “But when I walked in the next morning, I got the shock of my life.”

The patient was well on the road to recovery.

Marik tried this treatment with the next two sepsis patients he encountered, and was similarly surprised. With such good results, he started treating his sepsis patients regularly with the vitamin and steroid infusion.

After he’d treated 50 patients, he decided to write up his results. As he described it in Chest, only four of those 47 patients died in the hospital—all those deaths were from the underlying diseases, not from sepsis. For comparison, he looked back at 47 patients the hospital had treated before he tried the vitamin C infusion and found that 19 had died in the hospital.

Dr. Craig Coopersmith, a surgery professor at Emory University School of Medicine, commented, “If it turns out in further studies this is true, and we can validate it, then this will be an unbelievably huge deal. But right now, we should treat it as a preliminary deal that needs to be validated.”

What’s Next?

Dr. Fowler, and colleagues from Wake Forest, University of Virginia, and Emory, have received a $3.2 million grant from the National Institutes of Health (NIH) to run a carefully controlled study of vitamin C to treat sepsis, with all the usual conditions: It includes placebos; the scientists don’t know who’s getting the active drug; and it’s being conducted at several universities.

The study could wrap up later this year. Fowler says some patients in the trial will probably have been given corticosteroids, as Marik’s patients were, but that’s not a formal part of the study.

“We are looking to test vitamin C as an intervention for early lung injury due to sepsis. Our goal is to enroll about 170 patients among the four research sites in the next two to three years,” Fowler says. “This research is important because the current standard of care doesn’t work and it is expensive. We’re hopeful that vitamin C might be an effective intervention that will save lives.”

While we wait for the results of the studies, doctors would like to remind you of the following ways to fight the contraction of sepsis:

  • Get vaccinated against the flu, pneumonia, and any other infections that could lead to sepsis.
  • Prevent infections that can lead to sepsis by cleaning scrapes and wounds and practicing good hygiene (hand washing).
  • Know that time matters. If you have a severe infection, look for signs and symptoms, including shivering, fever, extreme cold, extreme pain or discomfort, clammy or sweaty skin, confusion or disorientation, shortness of breath, and high heart rate.

If you have questions about this or any healthcare issue, contact the primary care providers at Coastal Carolina Health Care by calling (252) 633-4111 or visiting www.cchchealthcare.com.

(Sources: Centers for Disease Control and Prevention; CBS News; The Mayo Clinic; Medical News Today newsletter; Sepsis.org; Surviving Sepsis Campaign; and National Public Radio.)