Sepsis blood poisoning with lifelong consequences

Underestimated blood poisoning: Every year many people die of sepsis

13/09/2012

On today's World Sepsis Day events around the topic "sepsis" take place worldwide. The initiators of the action day want to inform about the largely unknown disease, the consequences of which annually about 60,000 patients die in Germany alone. More than 1,000 hospitals and organizations participate in the day of action. "Sepsis causes more deaths than breast cancer, prostate cancer and HIV / AIDS globally each year.

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

Blood poisoning is often underestimated
Every year, around 150,000 people in Germany contract sepsis. For 60,000 patients, the disease, which is largely unknown in the population, ends fatally. Few people are aware of what sepsis is and what causes the disease. "Here there is a clear mismatch between the awareness and the frequency," says Reinhart to "World Online". With the World Sepsis Day, the initiators want to bring the disease more into the public consciousness and inform about the dangers of "blood poisoning", as sepsis is colloquially called.

In Berlin, a sea of ​​lights from candles at the Brandenburg Gate is planned for the evening. The background of this action is the symbolic meaning of the duration of the burning of a tealight. Because at the same time - about four hours - should be started with the treatment of sepsis, to avoid life-threatening complications. The sooner a sepsis is diagnosed and treated, the higher the chances of survival of the person affected, which drops by eight percent per hour. This is what intensive care physician Anand Kumar from the University of Manitoba in Winnipeg, Canada, and his team found out in the evaluation of more than 2700 patient data. "The candles are survival lights, but at the same time we want to remind them of the people who died of sepsis. In Germany this is around 60,000 people every year. Improved hygienic measures in the clinics can also reduce this number. Therefore, 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 sensitize and win over decision makers and interest groups. Since it was logical, u.a. to organize such an event at a central location such as the Brandenburg Gate in Berlin. But of course we are also active in Jena on September 13. "On the Ernst-Abbe-Platz from 17 clock actions and information on" sepsis "are planned. In addition, there should also be a sea of ​​lights, as informed by the University Hospital Jena in its current press release.

Immediately act on blood poisoning
"Sepsis needs to be more aware of both patients and physicians. Last but not least, timely treatment determines life and death, "Reinhart told 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 white blood cell count are nonspecific. This will waste precious time. "

Rapid administration of antibiotics can reduce 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 get antibiotics within an hour," he tells the newspaper.

Sepsis can always occur when a focus of inflammation spreads a large number of pathogens directly into the bloodstream. Common bacteria such as staphylococci, streptococci or rod-shaped intestinal bacteria can then cause devastating damage.

"Sepsis is a medical emergency. Therefore, we are glad that in a Jena pilot project corresponding antibiotics are already kept in the ambulance or in the helicopter in order to be able to react directly, not only in the clinic, "says Reinhart. "An early and successful sepsis treatment shortens the length of stay in the intensive care units and in the hospital." Thus, both the patients and the payers benefit from a speedy treatment, it says in the press release of the hospital.

Often, pneumonia is preceded by blood poisoning
Often the site of inflammation is a previous pneumonia or infection. Sepsis always occurs when the local defense mechanisms are no longer effective. Normally the immune system reacts immediately to an infection. Clotted blood then collects around the site of inflammation and builds up a protective barrier so that the pathogens with their toxic metabolic products can not spread further. If this defense mechanism no longer functions, it can lead to the so-called "systemic inflammatory response syndrome" (SIRS). At the same time, the inflammatory reaction takes place throughout the body, regardless of the original source of infection. Sufferers suddenly show severe symptoms such as rapid heart rate, a significantly changed body temperature and respiratory distress and are often even mentally confused. These alerts should be used immediately in a hospital - especially if there is a source of infection.

If the patient does not receive immediate treatment with antibiotics, his condition deteriorates rapidly and dramatically. It follows the impairment of vital organs such as liver, kidney and heart. If it comes to septic shock, the blood pressure can not be maintained and the organs fail completely. At this stage, the patient dies in most cases despite antibiotics, oxygen mask and fluid infusions.

Due to the high mortality in sepsis, Reinhart advises certain groups of people to be prophylactic. "The causative agents of pneumonia, the pneumococci, are the most common cause of sepsis. If more high-risk patients were vaccinated against it, many deaths could be prevented, "he says. Above all, people over 60 years and patients with a primary disease such as cancer or immunodeficiency Reinhart advises to inform about a vaccine prophylaxis at their family doctor.

Unfortunately, prophylaxis can not prevent all blood poisoning, therefore, Reinhart advises Leihen and doctors alike to take the warning symptoms very seriously and to ensure the earliest possible treatment. "If we do not counter sepsis now, more and more people will get sick," the physician told the online portal. More and more people are suffering from sepsis. Between 2000 and 2008, the number of sepsis cases increased by 100 percent. According to Reinhart's view, the cause lies in the improved medical care. "There are more risky people today. Even people with multiple chronic illnesses often reach a very old age. Your body is more susceptible to serious infectious diseases, "reports the sepsis expert.

To improve coverage of sepsis patients, the MEDUSA network in Germany is making a decisive contribution. "Therapy steps are documented precisely in all sepsis patients of the participating intensive care units. The aim of the study is to reduce the time to the first administration of antibiotics, "reports Reinhart. Forty hospitals are currently participating in the study nationwide.

Blood poisoning affects the brain
If patients survive a life-threatening sepsis, their ordeal is often not over. According to researchers from the University Department of Neurology in Bonn, septic shock often permanently affects the brain's memory function. "Our study has shown that in severe sepsis, the central memory region - the hippocampus - is damaged," said the co-author of the study, Catherine Widmann, compared to "World Online".

The hippocampus is a particularly metabolically active region in the brain and therefore requires a lot of oxygen and glucose. However, both can not be delivered in shock, structurally damaging the hippocampus. "Compared to healthy study participants, those subjects who have undergone severe sepsis showed a clear and lasting impairment of memory and learning," explains Widmann.

"In the treatment of severe sepsis, the main focus is still on the cardiovascular system. The damage to the brain is unfortunately still underestimated and currently not treated, "says Michael Heneka, working group leader of the research laboratory of Widmann, to the world and calls for better follow-up care for sepsis patients. "We have a large group of sufferers who are not yet adequately cared for their permanent cognitive impairment, the expert reports. "They urgently need a contact person who advises them and treats possible cognitive deficits." (Ag)

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