September 13 is World Sepsis Day. Sepsis occurs when the body’s response to an infection damages organs and tissues. It is the primary cause of death from infection and hospitalizes 30, 000 Canadians every year. The most severe cases result in septic shock, characterized by low blood pressure and cellular and metabolic abnormalities. Sepsis is typically treated with antibiotics and other supportive measures such as ventilation.
CHÉOS Scientist Dr. Joel Singer and statistician Dr. Terry Lee were authors on a recently published study examining previous septic shock clinical trials for vasopressors, which help raise blood pressure. Previous research found no effect on mortality, but the study’s authors hypothesized that vasopressors may provide other benefits in combatting organ dysfunction that were overlooked. In reviewing the data from earlier trials, they determined that depending on what outcomes were used in the analysis, different vasopressors appeared to be more beneficial. The study’s results also highlight the need for a consistent primary endpoint that can be used to better ascertain the effectiveness of sepsis treatments.
Dr. Peter Dodek, another CHÉOS Scientist, has also been involved in sepsis treatment research. He contributed to the creation of a clinical practice guideline for using corticosteroid therapy for sepsis. Corticosteroids are thought to possibly improve the immune response and increase blood pressure. Based on a review of 42 clinical trials and the most recent evidence, there was some evidence that corticosteroids might reduce risk of death and slightly increase neuromuscular weakness. With these findings and consultations with a panel of sepsis survivors, family care givers, various clinicians, and researchers, the study’s authors make a weak recommendation in favour of corticosteroid use for all patients, though patient values and preferences should factor into the decision. This deviates from previous guidelines that advised against giving corticosteroids except in cases with refractory shock.
Although timely recognition and treatment are critical in helping to reduce sepsis mortality, World Sepsis Day also emphasizes that many sepsis cases can be prevented through vaccination and improved hygiene and sanitation. To learn more about sepsis watch this quick three-minute video from the organizers of World Sepsis Day or check out what is being done to combat sepsis in British Columbia.