Sepsis, a life-threatening condition arising from an overactive immune response to an infection, is a silent killer that can lead to organ damage, shock, and even death. Despite advancements in healthcare, sepsis remains a severe threat with high mortality rates, especially affecting vulnerable populations like the elderly, individuals with compromised immune systems, and pregnant women. According to the World Health Organization (WHO), nearly half of all sepsis cases occur in children under five years of age.
To understand the complexities of sepsis and its impact on global health, we spoke with Dr. Sandeep Dewan, Senior Director and Head of Critical Care at Fortis Memorial Research Institute (Gurugram).
Unraveling the Mystery of Sepsis
“Sepsis is a syndrome where an infection originates in a specific part of the body and spreads through the bloodstream, causing organ dysfunction. Sepsis manifests in various forms. The early stage, known as Systemic Inflammatory Response Syndrome (SIRS), is characterized by inflammation. The later stage, called septic shock, occurs when the infection spreads in the bloodstream, leading to a decline in the patient’s blood pressure.” explains Dr. Dewan.
Why Early Detection is Crucial
The mortality rate associated with sepsis remains alarmingly high despite advances in healthcare. Dr. Dewan emphasizes, “Sepsis carries a high mortality rate, with 40-50% of patients succumbing to the condition. Even a one-hour delay in antibiotic prescription in a sepsis case can increase mortality by 4 to 5%. This underscores the critical importance of early detection.”
Identifying the early signs of sepsis is crucial for timely intervention. Dr. Dewan shares, “Common early signs of sepsis include fever, breathing difficulties, nausea, and drowsiness due to a drop in blood pressure. Any healthcare professional observing these signs should suspect sepsis and immediately admit the patient for treatment.”
The Variability of Sepsis and Risk Factors
Dr. Dewan highlights the individualistic nature of sepsis, stating, “Sepsis varies from patient to patient, influenced by their immune system’s strength. For instance, individuals in the elderly population, those with comorbidities such as heart failure or asthma, patients undergoing cancer treatment, and those on steroids have compromised immunity, making even minor infections potentially life-threatening. This emphasizes the need for heightened vigilance, especially for individuals above 65 years of age, to seek medical attention for any early signs of sepsis.”
Pregnancy and the Increased Risk of Sepsis
Dr. Dewan explains, “Pregnancy is considered an immunocompromised state, putting pregnant women at a heightened risk of developing sepsis. Preventive measures focus on early detection and recognition of sepsis features. If there are any doubts, prompt medical attention is crucial.”
Common Infections During Pregnancy and Management
Dr. Dewan shares, “Common infections during pregnancy include urinary tract infections and pneumonia. Effective management involves early detection, prompt medical attention, and immediate initiation of antibiotic therapy.”
Protecting Mothers and Children
Dr. Dewan emphasizes the importance of early detection and treatment for both the mother and child, stating, “Healthcare providers must prioritize the early detection and management of sepsis in pregnant women and newborns to protect their health.”
Postoperative Sepsis: A Major Concern
Dr. Dewan explains, “Postoperative sepsis is a concern, particularly in patients with underlying conditions that increase their risk of infection. Even with surgery, sepsis can arise postoperatively due to weakened immunity and surgical stress.
High-Risk Patients and Sepsis
“High-risk patients are prone to sepsis and sepsis-related deaths due to their compromised immunity. Surgical procedures add stress to the body, which, combined with weakened immunity, elevates the risk of sepsis development in postoperative patients.” says Dr. Dewan.
Technological Advancements for Early Detection
Dr. Dewan highlights advancements in sepsis detection, stating, “A variety of blood tests are available, including traditional and advanced methods. Traditionally, complete blood counts have been used to assess sepsis. However, newer markers like C-reactive protein (CRP) and serum procalcitonin provide additional insights. Bio-Fire technology, which identifies the type of organism entering the body, further enhances early detection.”
Bridging the Gap in Resource-Limited Areas
Dr. Dewan underscores the importance of telemedicine in resource-limited areas, stating, “In resource-constrained settings, telemedicine should be extensively utilized to connect patients in rural areas with specialized doctors in larger hospitals. This enables junior doctors to receive guidance from specialists, facilitating early detection and treatment of sepsis.”
The insights provided by Dr. Dewan highlight the urgency for enhanced awareness, early detection, and prompt treatment of sepsis. By understanding the complexities of this life-threatening condition, we can work together to improve patient outcomes and reduce the devastating impact of sepsis on individuals and communities worldwide.
