How do you talk about a horrible and life-threatening condition in such a way as to make your audience aware of its existence, but without scaring them so much that they turn a deaf ear? And how do you get money for research into something that most people have barely heard about – or only know of under an old and partly incorrect name? This is the problem that a team of LU researchers are tackling.
The condition is sepsis, previously referred to as blood poisoning. Sepsis is the consequence of a serious infection, although not necessarily in the blood; it could equally start from a case of pneumonia or an infection of the urinary tract or skin.
In case of sepsis, the immune system has gone into overdrive and released a lot of substances which cause the blood vessels to leak fluid. Blood pressure falls, leading to damage to the kidneys, heart and brain. In the worst cases, the patient dies within a matter of hours.
“The over-reaction of the immune system can be compared to using an atomic bomb to defend your country. You kill the attackers, but you also endanger the lives of the local population!” said physician and researcher Adam Linder.
His research is concerned with finding a new way of diagnosing sepsis. One problem is precisely that its symptoms – including fever, low blood pressure, high pulse-rate, aches in the body and confusion – also occur in milder conditions. Adam Linder hopes that a particular protein released by the white blood cells can determine which patients are at risk of severe sepsis and need intensive treatment.
Together with professor of infection medicine Heiko Herwald and professor of respiratory medicine Arne Egesten, Adam Linder has also taken the initiative for a conference in Lund on 17–18 September. The conference is to gather physicians and researchers from all over the country to build up a network for sepsis research.
“We are approximately in the same position as we were when diabetes and cancer were less well-defined conditions. Neither the general public nor healthcare knew much about the diseases, and there were no particular research funds”, said Adam Linder.
He would like healthcare professionals to be aware that approximately every fifth sepsis patient who is admitted to hospital risks developing a grave, life-threatening condition within twenty-four hours. If the physicians do not understand the gravity of the situation, the patient may receive insufficient treatment or end up on a ward with less frequent monitoring.
There are several reasons why so little is known about sepsis, according to Adam Linder. One is that infections are no longer perceived as being so dangerous, since even life-threatening infections such as TB can be cured. Another reason is that physicians themselves rarely talk about sepsis, saying instead that the patient “died of pneumonia”.
How then to increase awareness of sepsis in an appropriately cautious manner? After all, it is a frightening ability in each individual’s immune system to run amok. Adam Linder is very much aware of the problem.
“We have to try and walk a tightrope. We don’t want to make people hysterical, but we still want to put pressure on public healthcare and decision-makers to draw attention to sepsis. This condition is so serious that we cannot afford to remain passive!”
Text: Ingela Björck
Photo; Roger Lundholm
FACT: Severe sepsis is one of the most common causes of death worldwide. A patient with sepsis is five times more likely to die than a patient with a stroke or a heart attack.
In the developing world, sepsis is the cause of 60–80 per cent of all deaths, often in newborns and pregnant women.
With immediate intervention using strong treatment, four out of five patients will survive. The chances of survival then drop rapidly with every passing hour without treatment.