Giving props to sepsis

On September 23, 2008, in health care, quality, by Karen Grepin

For some unknown reason, I know a lot of people who are very passionate about sepsis. Sepsis is one of those super, super neglected diseases, because in fact is is not really a disease, rather it is a complication of many diseases. It happens all of the time, it is highly fatal, and yet it goes largely unnoticed by policy makers. Shall we start calling it an NTC? A recently published article on sepsis begins by describing sepsis as a “progressive injurious process resulting from a systemic inflammatory response to infection”. Sheesh. We need to work on marketing this thing a bit better…how about “Whole body overload”…or “eating you from the inside out”?

While case fatality from sepsis is relatively high, even in developed countries, the article described above outlines possible prevention and treatment strategies that may go a long way in saving lives. I have no idea how hard these things are to implement in practice, but some of these things seem pretty easy to a naive outsider: hydration, basic antibiotics, and popping a Zantac might help reduce morbidity and mortality from this condition. A friend of mine conducting research in Uganda on improving case management of sepsis, has suggested that training the friends and family members accompanying loved ones in the hospital, may be able to reduce morbidity and mortalty from sepsis by just telling them to call a doctor if the fluid bags in the hospital room runs low.

This article, my friend’s work, the work of others such as Atul Gawande’s work on lists for surgery, suggests that many of the improvements required to improve quality of care in developing countries can be done with very little money but will require a lot of intensive research in adopting clinical practices to real world experiences.

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