2nd WSC – Evidence Based Treatment of Sepsis II Now Available

Session 9 from the 2nd World Sepsis Congress - ‘Evidence Based Treatment of Sepsis II’ - is now available to recap on YouTube (embedded above) and as a Podcast on Apple Podcasts (iTunes link).
It is chaired by Markus Weigand from Germany and features the following presentations:

  • Peter Hjortrup - Fluids - Less May Be More

  • Naomi Hammond - The Type of Fluid Matters

  • Yasser Sakr - Human Albumin in Sepsis

  • Didier Payen - Current Evidence for Cytokine and Endotoxin Removal

  • John Myburgh - Vitamin C and Antioxidants

  • Anders Perner - “Primum Non Nocere” (First, Do No Harm) in Sepsis

Sessions are released weekly on Thursdays. The next session is ‘Update on Adjunctive Sepsis Therapies’ on November 22th, 2018. Please head over to the 2nd WSC website for the full release schedule.

The 2nd WSC is brought to you free of charge by the Global Sepsis Alliance, fostering our aspiration to bring knowledge about sepsis to all parts of the world. If you enjoyed it, please consider making a donation.

Marvin Zick
Health Is in Our Hands – the Relationship Between Handwashing, Infection, and Sepsis
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Eighty-four percent of infection-related newborn deaths could be averted at a cost of just 9 cents for each life saved. Imagine, less than a dime — that’s the cost to make available basic preventive measures, according to professor Zulfiqar Bhutta and colleagues in The Lancet. These measures include clean birthing and clean postnatal practices, such as handwashing with soap, which has been shown to prevent nearly 40 percent of neonatal deaths.  

But reality is the uphill battle that midwives fight daily. I met one midwife in rural Zambia, where she works hard to gain the trust of women in her community and make her clinic a welcoming place. When women in such communities give birth in a health clinic, they are more likely to survive. But when we talked about what stands the way of her gaining trust, the midwife had a simple answer — water.

The lack of clean water at her clinic means staff who should be caring for patients are forced to make long trips to a well to get water for drinking and cleaning. It means some women who have a reliable water supply at home may feel safer giving birth there. It also means that there are times when the midwife has to choose between leaving a woman in late stages of labor to get water, or delivering a baby without first washing her hands.

That kind of choice forces healthcare workers into an impossible position. Common infections, which are easily prevented by handwashing, put patients at grave risk at the same time that midwives must attend to other patients requiring urgent care.

Sepsis is among the most tragic outcomes of poor hygiene in healthcare facilities. It’s a global emergency that Dr. Konrad Reinhart, chair of the Global Sepsis Alliance and widely recognized as an international leader in the fight against sepsis, also notes “is one of the few conditions to strike with equal ferocity in resource-poor areas and in the developed world.” (In the United States, an estimated 1 million people contract sepsis every year, and 15 to 30 percent of them do not survive.)

“Worldwide, sepsis is one of the most common deadly diseases,” says Dr. Reinhart. The Global Sepsis Alliance reports 31 million cases of sepsis every year, resulting in 6 million to 9 million deaths. Sepsis is the body’s reaction to an infection, and it can lead to organ failure, damage and death. It can be caused by relatively common infections, such as a skin or urinary tract infection, with healthcare-associated infections a common cause of sepsis.

But at highest risk are, of course, vulnerable newborns and mothers in low- and middle-income countries where sepsis accounts for 15 percent of all neonatal deaths and 11 percent of maternal mortality.

All healthcare facilities need to have soap and water readily available for staff, patients, and visitors, but a 2018 study of data from 129,000 healthcare facilities in 78 low- and middle-income countries found it startlingly absent. Only 44 percent of healthcare facilities surveyed had both soap and piped water. Fifty percent of healthcare facilities lacked piped water, 33 percent lacked basic toilets, and 39 percent lacked soap for handwashing. In developing countries, nearly one in six patients contracts an infection during hospitalization.

Preventing infections requires the availability of soap, water and sanitation, and consistent and correct hand hygiene. That includes the United States. Across the world, more than 60 percent of health workers do not adhere to proper hand hygiene. According to the Centers for Disease Control and Prevention, U.S. healthcare providers, on average, wash their hands less than half of the time they should. On any given day, one in 25 U.S. hospital patients has at least one healthcare-associated infection.

Prevention is cost-effective and Congress agrees on many issues of water and global health. The U.S. government has an important role, with the Water for the World Act of 2014, and the 2017 U.S. Global Water Strategy, which organizes 17 U.S. federal agencies with various roles in water policy. Through its 2013–2018 Water and Development Strategy, USAID is taking action to improve sanitation and hygiene in health facilities in many countries. Importantly, the agency recognizes that “the expansion and improvement” of water, sanitation, and hygiene programming overall is critical to improving its efforts on maternal and child survival.

Let’s work to meet the U.N. Secretary General’s recent call to action for the global community to achieve universal access to water, sanitation, and hygiene in all healthcare facilities by 2030. Governments and donors are starting to fall in line, and countries that have implemented programs such as sepsis prevention — which include water, sanitation, and hygiene — have seen dramatic increases in newborn survival.

The discovery of the effects of handwashing singularly revolutionized healthcare, though clearly we still have a ways to go…


The article above was written by Carolyn Moore, secretariat director of the Global Handwashing Partnership, an international coalition of organizations working to promote handwashing as key to health and development, and is shared here with her explicit consent. The views in the article do not necessarily represent those of the Global Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice.


Marvin Zick
2nd WSC – Evidence Based Treatment of Sepsis I Now on YouTube and Apple Podcasts

‘Evidence Based Treatment of Sepsis I’ - session 8 from the 2nd World Sepsis Congress - is now available to recap on YouTube (embedded above) and as a Podcast on Apple Podcasts (iTunes link).
It is chaired by Marc Ziegenfuss from Australia and features the following speakers:

  • Daniel de Backer, Belgium

  • Massimo Antonelli, Italy

  • Marlies Ostermann, UK

  • Kathy Rowan, UK

  • Jean-Louis Teboul, France

  • Madiha Hashmi, Pakistan

Sessions are released weekly on Thursdays. The next session is ‘Evidence Based Treatment of Sepsis II’ on November 15th, 2018. Please head over to the 2nd WSC website for the full release schedule.

The 2nd WSC is brought to you free of charge by the Global Sepsis Alliance, fostering our aspiration to bring knowledge about sepsis to all parts of the world. If you enjoyed it, please consider making a donation.

Marvin Zick
Reminder: Please Participate in the GSA Global Quality Measures Survey

Please participate in the GSA Global Quality Measures Survey, if you haven’t yet. As of this article, the survey is available in English, Spanish, and German, with Portuguese coming very soon.

Despite a recent resolution by the WHO and increasing worldwide recognition that sepsis poses a major global health threat, our knowledge of what sepsis surveillance, treatment, quality improvement (QI), and reporting practices look like across the world is surprisingly limited and fragmented. As a community of stakeholders from policy makers to healthcare providers, we need to know more about how these programs and practices vary between regions, between patient populations, and between healthcare settings.

The GSA is conducting a global survey, which will operate through 2 arms.
The first arm is a targeted survey that will be distributed to the head of every national government health agency in the UN member states. The second arm is a publicly available survey that is targeted to various healthcare providers, health administrators, and government health officials across the world. We aim for participation that includes every UN member state, from diverse types of healthcare providers, and from diverse patient populations.

The survey begins by clarifying respondents’ roles to ask only the questions that are relevant to them. The following 15-20 questions should take about 7-9 minutes to complete. All responses are anonymous, and no data will ever be released in a manner that would allow any specific healthcare institution to be singled out.

 

Purpose of the Survey

To characterize the current practices related to sepsis surveillance, treatment, quality improvement, and reporting worldwide.

 

Date Protection and Privacy

All data is s collected through REDCap, a fully encrypted and secure data abstraction platform that has become a global industry standard to maintain both security and privacy for protected health information (PHI) and personally identifiable information (PII) in clinical trials and human subjects research.

This survey does not ask any questions that constitute PHI. The risk of any responses being able to identify individuals or institutions is extremely minimal. Nevertheless, all data is fully encrypted and housed in a secure location. One only individual will directly access raw data for analysis, and all data reports will always presented in aggregate only.

 

Share the Survey

Please share the survey with your colleagues and other interested parties: www.worldsepsisday.org/survey

Marvin Zick
2nd WSC - Antimicrobial Therapy and Source Control II Now Available

Session 7 of the 2nd World Sepsis Congress ‘Antimicrobial Therapy and Source Control II’ is now available to view on YouTube (embedded above) and as a Podcast on Apple Podcasts (iTunes link).
It is chaired by Satish Bhagwanjee from the US and features the following speakers:

  • Beat Müller, Switzerland

  • Thierry Calandra, Switzerland

  • Alison Holmes, UK

  • Ana Gales, Brazil

  • David Paterson, Australia

  • Jeffrey Lipman, Australia

Sessions are released weekly on Thursdays. The next session is ‘Evidence Based Treatment of Sepsis I’ on November 8th, 2018. Please head over to the 2nd WSC website for the full release schedule.

The 2nd WSC is brought to you free of charge by the Global Sepsis Alliance, fostering our aspiration to bring knowledge about sepsis to all parts of the world. If you enjoyed it, please consider making a donation.

Marvin Zick
Presentations from WSD Supporter Meeting at ESICM LIVES 2018 in Paris
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On October 23rd, World Sepsis Day Supporters from all over the world came together at ESICM LIVES 2018 in Paris for a World Sepsis Day Supporter Meeting.

Konrad Reinhart, Chair of the Global Sepsis Alliance, Kubilay Demirag, Chair of the Turkish Society of Intensive Care, Maha Aljuaid, GSA Advance Speaker, and Marvin Zick, General Manager of the GSA, gave presentations, which you can view and download below. Imrana Malik, GSA Advance Coordinator, could not be there in person, but her slides are available below as well.

Additionally, WSD Supporters from all over the world reported on their activities and plans, and we discussed how we can jointly eradicate sepsis to make our vision “A World Free of Sepsis” a reality.


Summary of This Year’s GSA and WSD Activities - Marvin Zick


Strategy of the GSA to Implement WHO Sepsis Resolution - Konrad Reinhart


The Exemplary Success of the WSD Campaign in Turkey - Kubilay Demirag


GSA Advance - Imrana Malik


Progress of the National Sepsis Plan in Saudi Arabia - Maha Aljuaid


Our next World Sepsis Day Supporter Meeting will take place at ISICEM Brussels in March 2019. The exact date and location will be announced on our website early 2019 as well as send out via our newsletter. A form to sign up will be available here.

Marvin Zick
2nd WSC - Importance of Pathogen Detection and Sepsis Markers Now Available

The sixth session of the 2nd World Sepsis Congress ‘Importance of Pathogen Detection and Sepsis Markers’ is now available to view on YouTube (embedded above) and as a Podcast on Apple Podcasts (iTunes link).
It is chaired by Steven Opal from the US and features the following speakers:

  • Peter Keller, Switzerland

  • Beverley Hunt, UK

  • Marin Kollef, US

  • Evelien de Jong, The Netherlands

  • Tom van der Poll, The Netherlands

  • Michael Bauer, Germany

Sessions are released weekly on Thursdays. The next session is ‘Antimicrobial Therapy and Source Control II’ on November 1st, 2018. Please head over to the 2nd WSC website for the full release schedule.

The 2nd WSC is brought to you free of charge by the Global Sepsis Alliance, fostering our aspiration to bring knowledge about sepsis to all parts of the world. If you enjoyed it, please consider making a donation.

Marvin Zick
Paul Allen’s Cause of Death Revealed to Be Septic Shock, a Known Complication of Non-Hodgkin Lymphoma
 By Miles Harris [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons

By Miles Harris [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons

On October 15th, 2018, Paul Allen, co-founder of Microsoft, passed away at the age of 65 at the Swedish Medical Center in Seattle, Washington. While his cause of death was originally reported as “complications” of Non-Hodgkin Lymphoma, newly available documents (via TMZ) reveal his immediate cause of death was septic shock, resulting from underlying lymphoma-associated immunosuppression.

This is a profoundly sad outcome, but by no means a surprising one. There is a strong and undeniable relationship between cancer, its detrimental effects on the immune system, and the subsequent development of infections that lead to sepsis and septic shock. Cancer of all types increases the risk of developing sepsis by 10-fold(1). In addition, cancer patients have a 55% higher chance of dying from sepsis than noncancer patients(2).

The immune system of a cancer patient can be markedly suppressed by the cancer itself or by medications used to treat the cancer. This leads to a reduced ability to fight deadly bugs, as well as common organisms found throughout our environment, which generally do not pose a threat to healthy individuals. As a result, infections lead to sepsis which is often the final common pathway to death for cancer patients.

Sepsis remains one of the most underestimated (and under-reported) health threats worldwide, affecting 27 to 32 million people annually, of which 7 to 9 million die. Sepsis affects both rich and poor alike, although the burden is heavily weighted to the poor. However, early recognition and treatment can save many lives.

 

About Sepsis

Sepsis arises when the body’s response to an infection injures its own tissues and organs. Sepsis is an emergency; it may lead to shock, multiple organ failure, and death, especially if not recognized early and treated promptly. Sepsis is most common in people with compromised immune systems, like the very young, the very old, and those with chronic diseases like AIDS, cancer, diabetes, or Parkinson’s disease. But people can also develop sepsis from a simple scrape, wound, or burn injury. Septic shock is the most severe end of the spectrum. Organs begin to shut down and, unchecked, multi‐organ failure and death can ensue. Many patients who survive suffer from long-term disabilities.

 

About Paul Allen

Paul Allen was an American business magnate, philanthropist, and investor. He is best known for founding Microsoft with Bill Gates in 1975. He was estimated to be one of the wealthiest persons in the world, with an estimated net worth of $21.7 billion. He had a multibillion-dollar investment portfolio, including technology, real estate holdings, media companies, scientific research, and more. He founded the Allen Institute for Brain Science, the Institute for Artificial Intelligence, and Stratolaunch Systems. Over the course of his life, Allen gave more than $2 billion to education and arts, wildlife and environmental conservation, community services, healthcare, and more.

 

About the Global Sepsis Alliance and the World Sepsis Day Movement

The Global Sepsis Alliance (GSA) is a non-profit charity organization with the mission to provide global leadership to reduce the worldwide burden of sepsis. The GSA is initiator of World Sepsis Day on September 13th every year and World Sepsis Congress, a series of free online congresses bringing knowledge about sepsis to all parts of the world.

 

Press Release

A press release and contact persons for interviews are available.

 

Learn More About Sepsis

 

References

1. Martin et al. N Engl J Med; 348:1546 –1554; 2003.
2. Danai PA et al. CritCare Med 129:1432-1440;2006.

Marvin Zick