Sepsis, a condition of blood poisoning
A patient with Sepsis will have whole body inflammation. The problem is infection. Every year almost 18 million of people get affected with sepsis. If talked about the number of patients in USA, every 3 person out of 1000 suffer from this blood poison disease and the numbers of deaths due to severe sepsis in this country are 2 lakhs per year.
Millions of people die around the world due to sepsis. The numbers of people die due to the sepsis are either ever been to hospital or ever been hospitalised. 1 to 2 persons of all hospitalizations or 25 per cent of the ICU patients are the cases for sepsis.
The most important point is it is rarely reported that this hospitalization is the most significant factor. The patients of cancer or other type of serious illness have the complications and need ICU care, but the underlying factors of morbidity and mortality are either underestimated or kept under the carpet.
A study in the year 2016 by the AHRQ (Agency for Healthcare Research and Quality), of a few states have come up with the facts that out of 100,000 patients to have visited the hospitals, 651 had to stay there / were hospitalised because of sepsis.
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The most vulnerable cases of severe sepsis are children and the elderly people. Another revealing fact brought out by the AHRQ (Agency for Healthcare Research and Quality), in the year 2016, USA patients with multiple sepsis had to be readmitted in the hospital even after their treatments in the long term planned specialised hospitals or nursing homes, because of the severity of the problems.
Another study in the following year i.e. 2016, covering 18 states of the USA had observed that sepsis is the 2nd most common reason for the readmission in the hospitals within a month’s time.
A patient’s susceptibility to infection and the developments of sepsis depend much on the various medical conditions. The common risk factors of sepsis are age, the conditions that affect the immune system of the patients, like diabetes, burns, major trauma, absence of a spleen and cancer.
Sign & symptoms of Sepsis
Common signs and symptoms of sepsis are increased heart rate, fever and confusion. The symptoms may also accord with the type of infectionBecause of sepsis, blood pressure is sure to fall, which will follow shock. The further eventuality will be light headedness with the probability of intense bleeding or bruising.
Cause of sepsis
Infections in the lungs, the urinary tract and the abdomen are the most common causes of sepsis. Mostly infection in the lungs is responsible for 50 per cent of the septic cases. 30 to 50 per cent of the cases do not come with any definite source.
In most of the cases, bacteria are the main infectious agents, but viruses or fungi are also the next major causes for sepsis. Before a decade, gram-negative bacteria used to be the main cause of sepsis. At that time the disease was caused by staphylococci, which was responsible for 50 per cent of the sepsis cases. Fungal sepsis is responsible for 5 per cent of the septic shock cases and severe sepsis cases.
Diagnosis of sepsis
Earlier is always the better for diagnosing sepsis, so that it can be managed properly. If goal directed therapy is initiated early, it can reduce mortality to a great extent and prevent it from becoming severe.
WBC should be started within the very 1st 3 hours of its suspicion. Antibiotics should not be started until serum lactate is measured and appropriate culture is obtained. To find out causative organism, minimum 2 sets of blood cultures should be taken.
If the source of infection is suspected from others such as cerebrospinal fluid, urine, wounds, or respiratory secretions, testing them is necessary. But these tests should not delay the administration of antibiotics.
Treatments of sepsis
Antibiotics and intravenous fluids are the usual treatments of sepsis. All these treatments are done in the intensive care unit. In case of fluid replacements are not successful, medicines that can raise the blood pressure are the next alternative. In this stage, kidneys and lungs need external support system which is done by dialysis and mechanical ventilation. The treatment needs the involvement of an arterial catheter and central venous catheter. Measurements like superior vena cava oxygen saturation and cardiac output are also used in the treatment.
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