Global Review Of Sepsis Necessary

After a study done in Australia and New Zealand found that one in eight patients with infections severe enough to require admission into intensive care didn't meet current criteria, experts have called for a global review of guidelines.
Monash University researchers and the Australian and New Zealand Intensive Care Society (ANZICS) examined the data collected from over a million patients admitted to 172 Intensive Care Units over 14 years.
109,663 patients with infection and organ failure were identified as possibly having sepsis, yet despite these symptoms more than 13,000 patients from the group did not meet the classic criteria for diagnosing sepsis.
Lead researcher Dr Maija Kaukonen, from the Department of Epidemiology and Preventive Medicine at Monash University said that for many years, doctors around the world have used the same criteria to identify and categorise patients who are critically ill due to sepsis, a bloodstream infection that kills millions of people every year throughout the world.
“To be diagnosed with sepsis, a patient must be thought to have an infection and exhibit at least two of the following criteria: abnormal body temperature or white blood cell count, high heart rate, high respiratory rate or low carbon dioxide level in the blood,” she said.
“But our study found that many patients, for example the elderly or those on medications that affect heart rate or the immune system, may not meet the classic criteria to diagnose sepsis, despite having severe infections and organ failure. If we continue to use these criteria we may miss the opportunity to identify many critically ill patients with sepsis.”
Professor Rinaldo Bellomo, from the Australian and New Zealand Intensive Care Research Centre at Monash University’s School of Public Health and Preventive Medicine, who conceived the study, said that whilst the classic definition of sepsis has been widely used throughout the world, he believed that after 20 years, it was time for it to be reviewed.
"There are clear signs from this study, that if we continue to use these criteria, we may fail to identify septic patients and therefore potentially delay their treatment,” he said