Sepsis: blood poisoning with lifelong consequences

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Underestimated blood poisoning: Every year, many people die from sepsis

Today's World Sepsis Day will host events all around the theme of “sepsis”. The initiators of the campaign day want to educate about the largely unknown disease, the consequences of which annually kill around 60,000 patients in Germany alone. More than 1,000 hospitals and organizations take part in the campaign day. “Sepsis causes more deaths worldwide each year than breast cancer, prostate cancer and HIV / AIDS combined.

However, little is known about this condition. We want to change that on September 13, not just in Germany, but worldwide, ”says one of the initiators, Professor Konrad Reinhart, Director of the Clinic for Anaesthesiology and Intensive Therapy at the University Hospital Jena (UKJ) and Chairman of the Global Sepsis Alliance (GSA), quoted in the press release from the University Hospital.

Blood poisoning is often underestimated In Germany around 150,000 people develop sepsis every year. The disease, which is largely unknown to the general public, is fatal to 60,000 patients. Few people know what sepsis is and what triggers the disease. "There is a clear mismatch between awareness and frequency," says Reinhart to "Welt Online". With World Sepsis Day, the initiators want to raise public awareness of the disease and inform about the dangers of "blood poisoning", as sepsis is colloquially known.

In the evening, a sea of ​​candle lights is planned in Berlin at the Brandenburg Gate. The background to this action is the symbolic meaning of the duration of the burning off of a tea light. Because at the same time - about four hours - the treatment of sepsis should be started to avoid life-threatening complications. The earlier a sepsis is diagnosed and treated, the higher the chances of survival for the person affected, which drops by about eight percent per hour. This is what intensive care doctor Anand Kumar from the University of Manitoba in Winnipeg, Canada, and his team found out when evaluating more than 2,700 patient data. "The candles represent survival lights, at the same time we want to use it to particularly remind people who died of sepsis. In Germany this is around 60,000 people annually. This number can also be reduced through improved hygiene measures in the clinics. That is why we want to draw the general public's attention to the topic and, at the same time, reduce mortality rates in the long term through patient-oriented research and cooperation, ”reports Reinhart. "Of course we also want to raise awareness and win over decision-makers and interest groups. It was logical, among other things to hold such an event in a central location such as the Brandenburg Gate in Berlin. But of course we will also be active in Jena on September 13th. ”Actions and information on the topic of“ sepsis ”are planned on Ernst-Abbe-Platz from 5 pm. In addition, there should also be a sea of ​​lights, as the University Hospital Jena informs in its current press release.

Take immediate action in case of blood poisoning “The sepsis must become more conscious of the patients, but also of the doctors. Last but not least, timely treatment determines life and death, ”Reinhart explains to the daily newspaper“ Die Welt ”. Frank Brunkhorst from the Jena sepsis center knows the problem: “Even today, sepsis is often diagnosed too late. This is because symptoms and laboratory values ​​such as fever, accelerated heartbeat or the increased number of white blood cells are not specific. This wastes valuable time. "

Rapid antibiotic administration can limit the spread of the infection and in most cases save the patient's life. Reinhart has therefore formulated an ambitious goal. "We want every patient to be given antibiotics within an hour," he told the newspaper.

Sepsis can always occur when an inflammatory focus spreads a large amount of pathogens directly into the bloodstream. Widespread bacteria such as staphylococci, streptococci or rod-shaped intestinal bacteria can then wreak havoc.

“Sepsis is a medical emergency. This is another reason why we are glad that in a Jena pilot project appropriate antibiotics are already held in the ambulance or in the helicopter so that we can react immediately, not just in the clinic, ”says Reinhart. "Early and successful sepsis treatment shortens the length of stay in the intensive care units and in the hospital." This means that both the patient and the cost bearers benefit from prompt treatment, the clinic's press release says.

Pneumonia often precedes blood poisoning. The focus of the inflammation is often a previous pneumonia or an infected wound. Sepsis always occurs when the local defense mechanisms no longer work. The immune system usually responds immediately to an infection. Coagulated blood then collects around the focus of inflammation and builds a protective barrier so that the pathogens can no longer spread with their toxic metabolites. If this defense mechanism no longer works, so-called “systemic inflammatory response syndrome” (SIRS) can occur. The inflammatory reaction takes place equally throughout the body, regardless of the original source of the infection. Those affected suddenly show severe symptoms such as a rapid pulse, a significantly changed body temperature and shortness of breath and are often even mentally confused. With these warning signals, those affected should be immediately taken to a hospital - especially if there is a focus of infection.

If the patient does not receive antibiotic treatment immediately, his condition worsens dramatically. This is followed by the impairment of vital organs such as the liver, kidney and heart. If septic shock occurs, blood pressure cannot be maintained and the organs fail completely. At this stage, the patient dies in most cases despite antibiotics, an oxygen mask and liquid infusions.

Due to the high mortality rate in sepsis, Reinhart advises certain groups of people to prophylaxis. “Pneumococci, the causative agent of pneumonia, are particularly often the cause of sepsis. If more risk patients were vaccinated against it, many deaths could be prevented, ”he says. Reinhart especially advises people over the age of 60 and patients with an underlying disease such as cancer or an immune deficiency to find out about vaccination prophylaxis from their family doctor.

Unfortunately, prophylaxis cannot prevent all blood poisoning, which is why Reinhart advises lenders and doctors alike to take the warning symptoms very seriously and to ensure that treatment is given as early as possible. "If we do not counteract sepsis now, more and more people will become ill," the doctor explains to the online portal. Because more and more people get sepsis. Between 2000 and 2008 the number of sepsis cases increased by 100 percent. According to Reinhart, the cause was to be found in the improved medical care. “There are simply more risk patients these days. Even people with multiple chronic illnesses often live to a very high age. However, your body is more susceptible to serious infectious diseases, ”reports the sepsis expert.

The MEDUSA network in Germany makes a decisive contribution to the better nationwide care of sepsis patients. “Thereby, the therapy steps for all sepsis patients in the participating intensive care units are precisely documented. The aim of the study is to reduce the time until the first antibiotics are given, ”reports Reinhart. 40 hospitals nationwide are currently participating in the study.

Blood poisoning affects the brain If patients survive life-threatening sepsis, their suffering is often not over. According to researchers from the University Clinic for Neurology in Bonn, septic shock often permanently affects the brain's memory function. "Our study was able to show that severe sepsis damages the central memory region - the hippocampus", the study co-author, Catherine Widmann, told Welt Online.

The hippocampus is a particularly metabolically active region in the brain and therefore requires a lot of oxygen and glucose. However, neither can be provided in the state of shock, which structurally damages the hippocampus. "Compared to healthy study participants, those subjects who had severe sepsis showed a clear and permanent impairment of memory and learning ability," explains Widmann.

“When treating severe sepsis, the main focus is still on the cardiovascular system. The damage to the brain is unfortunately still underestimated and is currently not being treated, ”reports Michael Heneka, working group leader of the research laboratory at Widmann, to the world and calls for better aftercare for sepsis patients. "We have a large group of people affected here who are not yet adequately cared for with regard to their permanent cognitive impairment," reports the expert. "They urgently need a contact person who will advise them and deal with any cognitive deficits." (Ag)

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