HOUSTON – (Sept. 13, 2012) – From clinical trials looking at new medications to implementing innovative tools for early detection, researchers and clinicians at The University of Texas Health Science Center at Houston (UTHealth) are looking for ways to lower the mortality rate of sepsis.
Sepsis is caused when the body reacts to infection with an overwhelming immune response, releasing chemicals that cause widespread inflammation that can damage the body’s organs. According to the National Institutes of Health, 750,000 Americans each year are diagnosed with sepsis and between 28 and 50 percent of these people die, more than the number of deaths from prostate cancer, breast cancers and AIDS combined.
UTHealth physicians will participate in today’s Texas Medical Center’s World Sepsis Day Awareness by highlighting their research. The event will be held from 10 a.m. to 2 p.m. in the John P. McGovern Texas Medical Center Commons waterwall building, 6550 Bertner at Moursund.
Robert Lodato, M.D., Ph.D., has been researching sepsis for three decades. Lodato, associate professor of internal medicine at the UTHealth Medical School, has just completed two clinical trials looking at agents that decrease the body’s inflammatory response in sepsis.
Bela Patel, M.D., is investigating another novel therapy to lower inflammation and potentially improve survival. Patel, associate professor and director of the Division of Critical Care at UTHealth, is also working with Trevor Cohen, Ph.D., to develop an electronic interface that would more efficiently alert physicians to early sepsis conditions in the body. Cohen is assistant professor at the UTHealth School of Biomedical informatics.
“Right now, early detection leading to prompt treatment is the only proven way to reduce mortality from sepsis,” Patel said.
In 2007, UTHealth launched a two-year quality improvement project assessing a group of interventions designed specifically for early detection of sepsis. The new system resulted in a 19 percent reduction in mortality and savings of $525,600 in medical costs. Patel and James McCarthy, M.D., associate professor of emergency medicine at UTHealth, led the study. After that study, a rapid response team composed of highly trained nurses and respiratory therapists was expanded to continuously survey patients and immediately initiate therapy upon recognition.
Building on that process, an acute care surgery team recently created a sepsis screening tool program. Laura J. Moore, M.D., assistant professor of surgery at UTHealth, said the screening tool is based on four variables collected as part of standard inpatient care: heart rate, respiratory rate, temperature and white blood cell count. Nurses screen bedside patients twice a day for sepsis and if the score is positive, they immediately notify the physician so that appropriate therapy can be initiated.
Researchers in the Section of Critical Care Nephrology in the Division of Renal Diseases & Hypertension at the UTHealth Medical School are currently conducting three different multi-center trials in patients with sepsis and shock. Kevin Finkel, M.D., professor and director of the Renal Division, along with collaborator Amber Podoll, M.D., assistant professor of internal medicine, are using different types of blood filters to remove harmful substances produced during sepsis.
In the RESCUE trial, burn patients with sepsis are treated with a method of cleaning the blood called hemofiltration in order to remove harmful proteins called cytokines produced in sepsis. It is thought that removing cytokines will improve survival rates. In the EUPHRATES trial, Finkel and Podoll are using a blood filter that can remove endotoxin from the blood. Endotoxin is a substance produced by certain bacteria during sepsis that is thought to directly decrease patient survival.
In the third trial, the researchers are using a novel blood filter called the selective cytopheretic device (SCD) in patients with acute kidney failure and shock. This device can inactivate white blood cells in the body. Although white blood cells are needed to control infection, they become overactive in sepsis and can damage otherwise healthy organs. By inactivating white blood cells with the SCD it is thought that organ damage will be reduced and patient survival will improve.
Deborah Mann Lake
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