Life-saving study into sepsis

Each year, over a million people suffer from sepsis. The death rate can rise to nearly 30% and 50% in severe cases – on a par with mortality rates for heart attack. It is becoming increasingly common as a result of the rising number of elderly or debilitated patients with underlying diseases, such as cancer, who require therapy; and due to the widespread use of antibiotics, which is encouraging the growth of drug-resistant microorganisms.

If recognised and treated early, sepsis has a favourable outcome but it can be difficult to diagnose and to appropriately treat at the early stage. The Leicester research project is looking at a safe alternative approach in assessing and managing patients with sepsis at the earliest stage. This is the use of a special monitoring device, called a Thoracic Electrical Bioimpedance monitor (Niccomo), which provides doctors with more information about how well the patient’s heart is working. The device operates on a very simple principle.

Four electrode patches, which are slightly larger than the patches used for ECG, are placed on the patient’s neck and chest. The patches transmit a low electrical current throughout the body, and the impedence of the signal received is then analysed by a computer. The approach is based on a proven technique already used on trauma patients suffering from heart failure.

Chris Vorwerk, a postgraduate student working on the project, commented: “I am an Emergency Physician (specialist registrar) working at the Leicester Royal Infirmary. Having seen many people dying from sepsis during my career as a doctor, it was my ambition to look into new ways of identifying and treating these patients at an early stage.”

She explained that doctors currently assess the severity of sepsis through invasive methods: “In some parts of the world, patients with sepsis are currently treated by placing a thin catheter into a blood vessel close to the heart. This allows doctors to assess the patient’s condition and to guide therapy. However, it is not without risk. It is more time consuming and requires a skilled operator, making it impractical for most UK emergency departments. Thoracic Electrical Bioimpedance monitoring is ideal for emergency department environments for distinguishing septic from non-septic patients, it is easy to use and allows continuous monitoring of changes during treatment.”

Chris Vorwerk said that she hopes to conduct a large randomised control trial to assess the device’s impact on survival rates and length of hospital stay.