Picture: An emergency 
Sepsis is an emergency
© Picture Disk

While incidence rates of sepsis have been steadily increasing over the years, little is known about the condition. Past investigational treatments have been based on data from small studies, and most of these therapies have failed.

For this analysis, researchers evaluated data from 1,886 of the study participants who were hospitalized with community-acquired pneumonia (CAP), the leading cause of severe sepsis. More than 30 percent of the subjects developed severe sepsis, of whom 26 percent died.

To determine the inflammatory response in the participants with CAP, the researchers measured cytokine levels. They found that 82 percent of the participants with CAP had elevated cytokine levels. Levels were highest when the subject presented at the emergency room, tapered down over the first few days, but remained elevated throughout the first week of hospitalization – even after the clinical signs of infection had subsided. Levels were highest in those with fatal severe sepsis, lowest in those with CAP but no sepsis.

“Our data show that much of what we previously thought about the role the inflammatory response plays in sepsis was wrong or incomplete. We had thought the inflammatory response to infection was relatively short-lived, just a few days, and that it was similar in patients with similar clinical signs. Instead, we found that the inflammatory response was extremely variable across patients—more than 50-fold differences were seen in some markers,” said John A. Kellum, M.D., professor, department of critical care medicine, University of Pittsburgh School of Medicine.

“Additionally, we found that the inflammatory response extends past the outward symptoms, far longer than previous data would suggest, and far longer than the courses of therapies used in unsuccessful clinical trials of experimental agents. We also found that the difference between the inflammatory response in a patient with a good outcome and a patient with a bad outcome is only a matter of degree.”

MEDICA.de; Source: University of Pittsburgh Schools of the Health Sciences