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Sepsis – the silent killer
It is a medical emergency and every minute counts. Don’t delay if you or a loved one experience the three symptoms of fast breathing, an altered level of consciousness such as feeling drowsy or sleepy and reduced urine output along with a suspected or confirmed infection.
Prof. Vasanthi Pinto
Dr. Bimal Kudavidanage
For, these symptoms could give an early indication of sepsis and immediate medical attention is a must, as otherwise the consequences could be disastrous and fatal.
This is the strong plea from two Consultant Anaesthetists & Intensivists as World Sepsis Day is commemorated today (September 13) to make people aware of this deadly disease.
“Sepsis is a silent killer,” reiterates Dr. Bimal Kudavidanage who is attached to the National Hospital of Sri Lanka (NHSL), while Prof. Vasanthi Pinto, Professor of Anaesthesiology & Critical Care of the Peradeniya Medical Faculty explains that sepsis takes a person down a slippery slope to death and it is essential to seek treatment immediately so that doctors can pull a patient back on time, before his/her condition deteriorates beyond redress. The global figures of the ravages of sepsis, which probably reflect the figures in Sri Lanka, are chilling.
There is 1 death per 3 seconds due to sepsis-related diseases worldwide, says Dr. Kudavidanage, putting on the table more disturbing data.
- 2.9 million children under the age of 5 years die each year of sepsis-related diseases of the 20 million affected by sepsis worldwide.
- 11 million adults die each year of sepsis-related diseases of the 50 million hit by sepsis worldwide.
So, what is sepsis?
Sepsis is caused when a person’s body has a “very severe” and “not normal” response to an infection, says Dr. Kudavidanage.
Usually, when a germ (bacterium, virus, fungus or parasite) enters a person’s body or an infection occurs due to an injury caused by trauma, the body’s immune system releases chemicals to fight the intruder. But sometimes there is an overwhelming release of such chemicals which, in turn, trigger inflammation, the Sunday Times learns.
Pointing out that then there is double trouble, Prof. Pinto says that this widespread inflammation can cause harm to organs such as the brain, heart, lungs, liver and kidneys and lead to severe organ damage and organ failure.
“This is deadly,” stresses Dr. Kudavidanage, explaining that such inflammation could trigger small (micro) blood clots which could reduce blood flow to limbs and internal organs, preventing adequate oxygen and nutrients reaching them and blood vessels could begin to leak or become distended causing a drop in blood pressure. Usually, the main cause of sepsis is a bacterial infection, it is understood, with even a very small cut or a tiny injury allowing the entry of bacteria.
With many people confusing the difference between sepsis and septicaemia, Dr. Kudavidanage explains that septicaemia is an infection in the blood, caused by bacteria in the bloodstream.
Those susceptible to sepsis include:
- Very young children in whom even a diarrhoeal infection could spark off sepsis.
- Expectant mothers.
- The elderly (over 60 years old) with co-morbidities (other chronic illnesses) such as diabetes.
- Those who have weakened immune systems due to cancer or HIV (Human Immunodeficiency Virus) or are on lifelong immuno-suppressants.
- Those who have been hospitalized or have had major surgeries.
- Those on invasive devices such as catheters or breathing tubes or have IV (intravenous) lines.
- Those who have a critical medical condition such as pneumonia, meningitis, cirrhosis or even a urinary tract infection or an ear infection.
- Those who have wounds including surgical wounds, accident wounds or even bed sores.
“Sepsis is a time-sensitive disease and early medical intervention is vital,” adds Prof. Pinto.
| Prevention the best cure | |
| Prevention is the best cure, stresses both Dr. Bimal Kudavidanage and Prof. Vasanthi Pinto giving some simple measures that can keep this illness away. They include:
The three stages of sepsis are – sepsis, septic shock and multi-organ failure, according to Dr. Kudavidanage and Prof. Pinto. Symptoms of sepsis – Rapid breathing (a high respiratory rate of over 20 breaths per minute); an altered level of consciousness – being drowsy, sleepy or confused; and reduced urine output along with low blood pressure, associated with a suspected or confirmed infection. Symptoms of septic shock – Symptomsof sepsis with very low blood pressure and reduced blood flow to the organs. Symptoms of multi-organ failure – Organs fail to function normally due to septic shock. To diagnose sepsis, doctors will do blood tests to confirm an infection; clotting problems; abnormal liver or kidney function; decreased amount of oxygen; an imbalance in minerals (electrolytes); and serum lactate levels to check the blood flow to the organs, says Dr. Kudavidanage. Referring to treatment, Prof. Pinto says that it would include antibiotics given intravenously to promptly fight the infection; medications and fluids given intravenously to increase blood pressure; insulin to stabilize blood sugar; corticosteroids to reduce inflammation and painkillers. While sepsis can be managed in a ward, septic shock will need management in the Intensive Care Unit (ICU) with various advanced medications and procedures.
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