Dr Sanjith Saseedharan, Director-Critical Care, S L Raheja Hospital talks about Sepsis, its treatment and management
Sepsis is a life-threatening condition caused by the body’s dysregulated immune response to an infection, which can be bacterial, viral, fungal, or parasitic. It can affect anyone, however the two ends of the age spectrum, the elderly and newborns (specifically premature infants), have a higher chance of developing sepsis with increased severity, due to their weak immune system. Pregnant women, individuals with comorbidities like Cancer, Diabetes Mellitus, Chronic Kidney Disease and Chronic Obstructive Lung Diseases also have a high chance of getting sepsis and its related complications.
Immunocompromised individuals like HIV patients, or patients who are on immunosuppressive medications like Chemotherapy are not only at a high risk of getting Sepsis, but also have a tough time recovering from it as compared to others. Individuals with indwelling devices that are used to administer medication or help perform biological functions, such as Hemodialysis Catheters or Urinary Catheters, are at increased risk of developing infections and potentially sepsis.
Patients who get Sepsis can start to exhibit symptoms like high temperatures (some may have low temperatures) with or without chills, a loss of appetite, a high pulse, skin rashes etc. If the infection becomes severe, symptoms are drop in blood pressure, reduction in urine output and an altered mental status. Symptoms may also vary depending on the particular organ system that comes under attack by the infection. If the respiratory system is involved, patient may experience persistent cough with or without production of greenish, yellowish or rusty phlegm, breathlessness, a very high respiratory rate, and chest pain. If the infection starts in the abdomen, the person experience vomiting, abdominal pain and alteration of bowel habits. If they have an in the brain, symptoms will be feelings of drowsiness, headache, may be confused or altered, and in worst-case scenarios they may become comatose.
There is no single course of treatment when it comes to Sepsis. It generally hinges on identifying the source of infection and then tackling it using appropriate control measures like drainage of accumulated fluids, if possible, along with judicious use of appropriate antibiotics. Many of these patients will require hospitalization and good proportion of these patient would need to be admitted to the Intensive Care Unit (ICU), and they may need strong intravenous medicines to keep the blood pressure up, some may require non-invasive or invasive ventilators, renal replacement procedures like Hemodialysis.
Awareness on the symptoms and causes of Sepsis is relatively low in India. The general public and primary health care providers need to be educated on the causes and symptoms so they can help avert Sepsis-related complications and death. They should also be trained to help prevent community-acquired Sepsis, which involves maintaining good hygiene, ensuring proper sanitation and water quality, educating people about cleanliness, safe food preparation, and vaccination where appropriate.
In healthcare settings, preventing infections relies on rigorous hand hygiene practices and optimal infection control measures. Organisations like the Indian Society of Critical Care Medicine and the Society of Critical Care continue to promote these essential practices. Early recognition, diagnosis and effective management is the key to surviving sepsis.