BECAUSE

Definition

Sepsis, also known as septicemia or sepsis, is a disease that affects the immune system. It is a serious condition, which is the complication of an infection in most cases. Normally, the function of the immune system is to protect us against attacks such as infectious agents. However, in some diseases, such as sepsis, this defense system turns against the body, a condition also known as an autoimmune disease.

Precise definition of sepsis (sepsis)
A definition of sepsis proposed in 2016 by 2 European scientific associations (Society of Critical Care Medicine & the European Society of Intensive Care Medicine) is as follows: a life-threatening disorder provoked by a response dysregulation of the host in the face of an infection.

Epidemiology

– Worldwide, there are an estimated 28 million cases of sepsis per year, with 8 million deaths. In early 2018, the University of Pittsburgh, which published a study on this disease, estimated that 14 million people worldwide survive hospitalization for sepsis each year.

– In the United States, an estimated 1 to 2 million Americans develop sepsis each year. There are approximately 500,000 deaths in this country. According to an April 2017 NPR (American public radio) broadcast, scientist John McDonough estimates that there are about 2 million cases of sepsis each year in the US, with a mortality rate of around 30%. According to John McDonough, about 25% of people who suffer from cancer do not die from cancer but from sepsis.

– According to the ILAS ( Latin American Sepse Institute ) report, it is estimated that Brazil has about 400,000 cases of sepsis per year, causing 200,000 deaths and high costs for the country, which becomes a serious problem. public health problem. In 2003 there were 398,000 cases and 227,000 deaths from septic shock in Brazil, always according to the ILAS.

A study published on January 18, 2020 in the prestigious medical journal The Lancet (DOI: 10.1016 / S0140-6736 (19) 32989-7 ) showed that septicemia (sepsis) causes one in five deaths worldwide, twice as many than previously believed. More than 40% of all new cases occur in early childhood. Lower respiratory tract infections (such as bronchitis, bronchiolitis, flu, or pneumonia) are among the most common underlying causes of these deaths, researchers found. Low- and middle-income countries, such as those in Africa, are by far among the hardest hit.

Causes

Septicemia is often caused by an infection, such as a virus or bacteria. Pus-generating bacteria (also called pyogenic germs), such as streptococci and staphylococci, are particularly at risk of causing sepsis when they form secondary infectious foci. Other causes can lead to sepsis such as the presence of another autoimmune disease, surgery (such as liposuction), etc.

Physiologically, sepsis is a response of the immune system to an infection in an exacerbated and very long way. Two types of bacterial infections that are often the cause of sepsis, especially in the elderly, are pneumonia and urinary tract infections. Genetic factors can also be the cause of sepsis.

Pathophysiology
According to a study published on April 8, 2016 in the specialized journal American Journal of Pathology, a protein called SHARPIN, with a specific role in anti-inflammatory regulation, could have a favorable effect in the fight against sepsis , as indicated by research performed in mice and humans. In patients with a low level of SHARPIN, the development of drugs that make it possible to increase the amount of this protein could have a positive effect in case of sepsis. This research was carried out by the Goethe University (Goethe-Universität) in Frankfurt am Main, Germany.

Some diseases like diverticulitis can lead to complications like sepsis.

Groups of risk

Some people are at greater risk of developing sepsis, such as those over age 65, those with diabetes or cancer, those taking immunosuppressive drugs, and those with weakened immune systems (for example, in AIDS). Infants are also at a higher risk of sepsis than adults, according to the Mayo Clinic .

The elderly and infants or very young children are most at risk because the immune system tends to be weaker in the elderly and not fully developed in infants.

Symptoms

Symptoms can be high fever, fatigue, increased heart rate, rapid breathing, pallor, loss of consciousness (syncope), etc. Some people with sepsis may suffer from mental disorders. If sepsis is not properly treated, the disease can lead to failure of organs such as the kidneys, brain or heart, leading the patient to death.

On a biochemical level, a person suffering from sepsis often has a high white blood cell count, high levels of inflammatory markers, etc.

Sudden Appearance
The symptoms of sepsis often appear suddenly and abruptly. For example, a person with a urinary tract infection may have mild symptoms and then suddenly have the typical symptoms of sepsis.

Septic shock 
If sepsis is not controlled, it can develop into septic shock – a serious stage that occurs when blood pressure drops and organs (eg heart, lungs, kidneys) stop.

Complications

It is estimated that 20 to 50% of patients die from complications of sepsis. For survivors, the consequences can be serious: amputations, lung and kidney damage.
In the United States, sepsis kills more people than HIV and breast cancer .

Treatments

Treatments for sepsis are non-specific and are mainly based on prevention, such as wound care.

People with sepsis may require hospitalization.

Medicines
Antibiotics, especially broad-spectrum ones, can be part of the treatment.
In addition to antibiotics, other medications can be used to treat symptoms such as low blood pressure.
Specific treatments for sepsis have yet to be proven.
Corticosteroids
When large doses of vasopressors are needed or blood pressure does not respond well in case of sepsis, hydrocortisone is often used by medical staff. In this case, early treatment with hydrocortisone reduces the risk of death and other side effects, as demonstrated in a study published in September 2020 in the journal SHOCK ® (DOI: 10.1097 / SHK.0000000000001651 ).

Septic Shock
People whose condition progresses to septic shock often require care in an intensive care unit, where they receive oxygen and IV fluids. Patients may also need a machine to help them breathe.

It is very important to treat infectious diseases such as pneumonia, urinary tract infection, meningitis, appendicitis, boils, toothache, paronychia to avoid complications and risk of sepsis.

Tips

In elderly people with cases of cystitis and frequent need to urinate, or with pneumonia , with severe cough and breathing difficulties, it is important to seek immediate medical attention to avoid complications.

Recovery after hospitalization for sepsis (study)
About half of patients hospitalized for sepsis who survive the illness do not fully recover, according to a University of Pittsburgh and University of Michigan study published Jan. Scientific Journal of the American Medical Association(Journal of the American Medical Association) (DOI: 10.1001/jama.2017.17687). US scientists mention a study that revealed that only 43% of patients, who were employed, returned to work after one year of septic shock (sepsis). To help patients who survive sepsis recover better and to help medical staff better manage the disease, scientists from the Universities of Pittsburgh and Michigan identified three important aspects when reviewing published studies on the subject:
1.Establish high-quality first care for sepsis, including rapid protocols to help the patient fight infection and manage pain through light sedation that allows the patient to be awake and oriented daily, as well as encourage early mobility during the patient’s hospitalization.
2. Post-discharge assessment and treatment leading patients to rehabilitation through physiotherapy, occupational therapy and speech therapy soon after discharge, and a quick orientation for caregivers if new problems or disorders develop.
3.Screening patients for conditions that may be present before hospitalization, such as high blood pressure, and adjusting post-discharge drug therapy taking into account patients’ greater susceptibility to new complications. Patients and caregivers should also be informed and trained about sepsis and the details of their hospital stay.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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