Tag: Sepsis

Sepsis Sleuths

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Sometimes we can be our own worst enemies without even realizing it. One devastating example is sepsis: our body’s overwhelming or impaired immune response to an insult—usually an infection or an injury to the body. According to the Centers for Disease Control and Prevention
(CDC)
, sepsis affects at least 1.7 million people in the United States each year, and it can lead to tissue damage, organ failure, and death. (See our sepsis fact sheet for more information.)

An outline of the United States composed of people icons, above text that reads: “Get ahead of sepsis. Know the risks. Spot the signs. Act fast.” Next to the map outline is text that reads: “At least 1.7 million adults in the U.S. develop sepsis each year, and nearly 270,000 die as a result.
Credit: CDC.
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In Other Words: Insult—A “Sick Burn” or a Burn That Makes You Sick?

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You probably think of a rude or offensive remark when you think of the word insult, but to biomedical researchers, an insult is the cause of some kind of injury to the body. Insults can come in a variety of forms, such as an infection or a physical trauma.

Below the title “Insult: In Other Words,” two images are separated by a jagged line. On the left is a woman covering her face with both hands as an eye looks at her and a mouth shouts at her. On the right are spherical bacteria on a rough surface. Under the images, text reads: “Did you know? In biomedical science, an insult is the cause of some kind of injury to the body.”
Credit: NIGMS.
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Career Conversations: Q&A with Immunoengineer Caroline Jones

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A headshot of Dr. Jones.
Dr. Caroline Jones. Credit: Moises Gomez.

“I find it fulfilling to be a scientist because I know that even if at some points it seems like I’m working on an incremental experiment, eventually it’s going to help solve a bigger problem,” says Caroline Jones, Ph.D., an assistant professor of bioengineering at the University of Texas at Dallas. Check out the highlights of our interview with Dr. Jones to learn about her career path, her passion for sharing science with the public, and her research on sepsis—an overwhelming or impaired whole-body immune response to an insult, such as an infection or injury that’s responsible for the deaths of nearly 270,000 Americans every year.

Q: How did you first become interested in science?

A: My mother was a high school math teacher, so I had that role model growing up. I also had a math and engineering teacher in high school who encouraged me and sparked my interest in the quantitative side of science. I decided to study biomedical engineering in college because I wanted to apply quantitative tools in a way that helped people.

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Career Conversations: Q&A with Clinician-Scientist Faheem Guirgis

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Dr. Guirgis in a white lab coat.
Dr. Faheem Guirgis. Credit: University of Florida, Jacksonville.

“Patients at urban and inner-city hospitals are in dire need of high-quality care and frequently don’t have access to clinician-scientists doing cutting-edge research. That’s part of what has made me committed to performing research in these settings,” says Faheem Guirgis, M.D., an associate professor of emergency medicine at the University of Florida College of Medicine, Jacksonville. Check out the highlights of our interview with Dr. Guirgis below to learn how he became a doctor and what inspired him to conduct research on sepsis.

Q: How did you become interested in science and medicine?

A: After the phase of wanting to be a firefighter or police officer, the next thing I remember wanting to be was a doctor. My father was and is my ultimate inspiration for pursuing a career in medicine. He was a family-practice physician committed to providing the best care possible for his patients before retiring recently, and they loved him.

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Stitching Together Basic Science and Surgery

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Sepsis researcher Dr. Philip Efron standing with his arm around Dr. Darden, who is giving a thumbs-up sign. Dr. Darden with her mentor, Dr. Philip Efron. Credit: Courtesy of Lyle Moldawer, Ph.D.

“I’m an African American woman from Memphis, Tennessee; you don’t see very many people like me in medicine or in science,” says Dijoia Darden, M.D. She’s working toward becoming an academic physician, which will allow her to treat patients, teach, and conduct research. “I’m hoping that as an academic physician, I can inspire other women, especially women of color, to pursue things they’re passionate about.”

A Path to Medicine

Dr. Darden was drawn to science from a young age, inspired by her microbiologist mother. She recalls that her mom often helped her create science fair projects, including one where she grew penicillin-producing bacteria taken from a lemon. Later on, during her high school summer breaks, Dr. Darden worked in a lab that studied how certain genes might contribute to cancer.

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Staying Safe From Sepsis

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This post was adapted with permission from the NIH News in Health article, “Staying Safe From Sepsis.”

Your immune system is on patrol every day. It protects your body from bacteria, viruses, and other germs. But if something goes wrong, it can also cause big problems.

Many small oblong shapes, some making up brightly colored clusters.
White blood cells undergoing a cascade of biochemical changes that is part of the immune response. Credit: Xiaolei Su, HHMI Whitman Center of the Marine Biological Laboratory.

Sepsis happens when your body’s response to an infection spirals out of control. Your body releases molecules into the blood called cytokines to fight the infection. But those molecules then trigger a chain reaction.

“Sepsis is basically a life-threatening infection that leads to organ dysfunction,” says Richard Hotchkiss, M.D., who studies sepsis at Washington University in St. Louis, Missouri. The most dangerous stage of sepsis is called septic shock. It can cause multiple organs to fail, including the liver, lungs, and kidneys.

Septic shock begins when the body’s response to an infection damages blood vessels. When blood vessels are damaged, your blood pressure can drop very low. Without normal blood flow, your body can’t get enough oxygen.

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Fight Against COVID-19 Aided by Sepsis Researchers

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Oblong light-blue structures with red spots in the middle connected to the surface of a sphere. Spike proteins on the surface of a coronavirus. Credit: David Veesler, University of Washington.

Since the start of the COVID-19 pandemic, researchers from many areas of biomedical science have worked together to learn how this new disease affects the human body, how to prevent its spread, and how to treat it. Severe cases of COVID-19 and cases of sepsis share many symptoms. Sepsis is the body’s overactive and extreme response to an infection. It’s unpredictable and can progress rapidly. Without prompt treatment, it can lead to tissue damage, organ failure, and death.

Sepsis has similarities with some cases of COVID-19, most likely because the two conditions trigger the same reactions at the cellular level. Researchers have studied these reactions in sepsis for many years.

“When we look back on 2020 and the speed with which progress was made against COVID-19, two features will stand out,” says John Younger, M.D., a member of the NIGMS Advisory Council who recently co-chaired a working group on advancing sepsis research. “The first is how quickly the biotechnology community came together to develop vaccine candidates. The second, and arguably the most immediately impactful, is how caregivers and clinical researchers were able to rapidly refine the care of COVID-19 patients based on decades of experience with sepsis.”

This post highlights a few of the many sepsis researchers supported by NIGMS who are applying their expertise to COVID-19.

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Shedding Light on Sepsis

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Sepsis is the body’s overactive and extreme response to an infection. It’s unpredictable, can progress rapidly, and affects more than 1.7 million people in the United States each year. Without prompt treatment, it can lead to tissue damage, organ failure, and death. NIGMS supports state-of-the-art sepsis research, including the development of rapid diagnostics and new therapeutics. September is Sepsis Awareness Month, and we’re highlighting a few resources that offer more information about this condition.

Our infographic provides details at a glance on basic statistics and the future of sepsis research. It’s also available in Spanish.

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Sepsis: Using Big Data to Cut a Killer Down to Size

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A geographical outline of the U.S. with the text More than 1.7 million people get sepsis each year in the United States. View the full infographic for more facts about sepsis.

Sepsis is a serious medical condition caused by an overwhelming response to infection that damages tissues and organs. It’s unpredictable, progresses quickly, can strike anyone, and is a leading cause of hospital-related deaths. In the U.S. alone, nearly 270,000 people die each year from sepsis. Those who survive sepsis often end up in the hospital again, and some have long-term health complications. Early treatment is key for many patients to survive sepsis, yet doctors can’t easily diagnose it because it’s so complex and each patient is different.

Despite decades of research, sepsis remains a poorly understood condition with limited diagnostic tools and treatment. To tackle these obstacles, scientists Vincent Liu, Christopher Seymour, and Hallie Prescott have started using a “big data” approach, which relies on complex computer programs to sift through huge amounts of information. In this case, the computers analyze data such as demographic information, vital signs, and routine blood tests in the electronic health records of sepsis patients. The goal is to find patterns in the data that might help doctors understand, predict, and treat sepsis more effectively.

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Quicker Sepsis Treatment Saves Lives: Q & A With Sepsis Researcher Christopher Seymour

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Sepsis is a serious medical condition caused by an overwhelming immune response to infection. The body’s infection-fighting chemicals trigger widespread inflammation, which can lead to blood clots and leaky blood vessels. As a result, blood flow is impaired, depriving organs of nutrients and oxygen. In severe cases, one or more organs fail. In the worst cases, blood pressure drops, the heart weakens, and the patient spirals toward septic shock. Once this happens, multiple organs—lungs, kidneys, liver—may quickly fail, and the patient can die.

Because sepsis is traditionally hard to diagnose, doctors do not always recognize the condition in its early stages. In the past, it has been unclear how quickly sepsis needs to be diagnosed and treated to provide patients with the best chance of surviving.

Credit: University of Pittsburgh.

Now we may have an answer: A large-scale clinical study, published recently in the New England Journal of Medicine, found that for every hour treatment is delayed, the odds of a patient’s survival are reduced by 4 percent. Christopher Seymour Exit icon, assistant professor of critical care and emergency medicine at the University of Pittsburgh, and his team analyzed the medical records of nearly 50,000 sepsis patients at 149 clinical centers to determine whether administering the standard sepsis treatment—antibiotics and intravenously administered fluids—sooner would save more lives.

I spoke with Seymour about his experience treating sepsis patients and his research on the condition, including the new study.

CP: How big a public health problem is sepsis?

CS: Our recent work with the Centers for Disease Control and Prevention suggests there might be as many as 2 million sepsis cases in the United States each year. I can share personally that sepsis, or septic shock, is far and away the most common life-threatening condition that I treat in the ICU (intensive care unit). It’s quite devastating, particularly among our elders, and it requires prompt care. Although the mortality rate may be decreasing, it’s still quite high. About 1 in 10 patients with sepsis don’t survive their hospital stay. Even young, healthy people can succumb from sepsis. And if you’re fortunate to survive, you can have significant problems with cognitive and physical function for many months to years down the line.

Unfortunately, the incidence of sepsis may even be increasing. More patients are surviving serious illnesses that used to be fatal. They’re alive, but their health is compromised, so they are at higher risk for sepsis. Also—and this is a positive—we are seeing greater recognition and increased reporting of sepsis. Both factors probably contribute to the higher numbers of reported sepsis cases.

CP: What are some of the biggest challenges in fighting sepsis?

CS: The first challenge is public awareness. It’s important that the public knows the word sepsis, that they’re familiar with sepsis being a life-threatening condition that results from an infection, and that they know it can strike anyone—young, old, healthy, or sick. But it’s also important to know that not every infection is septic, nor will every cut or abrasion lead to life-threatening organ dysfunction.

Another part of the problem is that sepsis is not as easy for patients to recognize as, say, myocardial infarction (heart attack). When patients clutch their chest in pain, they intuitively recognize what’s happening. Patients frequently don’t recognize that they’re septic. People should know that when they have an infection or take antibiotics as an outpatient, and they’re starting to feel worse or having other new symptoms, they may be at risk of sepsis. They should go to the emergency department or seek medical help.

The second challenge in fighting sepsis is that it’s just hard to diagnose, even for well-trained clinicians. Both issues can lead to delays in care, the most important of which is the delay in treatment with antibiotics.

CP: Tell me about your recent clinical trial. What question did you set out to answer?

CS: There’s been a lot of interest in the early recognition and treatment of sepsis over the past decade. Recently, the National Institutes of Health/National Institute of General Medical Sciences funded a large, multicenter trial called ProCESS, which tested various strategies for treating sepsis. This trial told us that a standardized sepsis protocol among people who had already received antibiotics didn’t necessarily change survival rates. But what it left unanswered was the very important question of when the patient first arrives at the emergency department, how fast do we need to provide antibiotics and fluids for the best possible outcome? Continue reading “Quicker Sepsis Treatment Saves Lives: Q & A With Sepsis Researcher Christopher Seymour”