Researchers from Charles Sturt University (CSU) have contributed to research that has the potential to radically change the way septic shock (septicaemia, also known as ‘blood poisoning’) can be treated around the world and save millions of lives and millions of health care dollars annually.
Professor Brendan Smith and Ms Veronica Madigan from the CSU School of Biomedical Sciences
in Bathurst have worked with colleagues at Bathurst Base Hospital and the University of Queensland since June 2007 to trial several novel strategies for the early detection and treatment of the condition. This includes, amongst other measures, using an ultrasonic cardiac output monitor (USCOM), an innovative Australian haemodynamic monitor created by Sydney-based USCOM Ltd
, as well as early antibiotic and drug therapy to arrest progress of the condition in the critical first few hours of the illness.
Professor Smith, who is also Director of the Intensive Care Unit at Bathurst Base Hospital, says the new methods they have developed to treat septic shock are based on early diagnosis and rapid USCOM-guided individualised treatment. This has reduced the mortality rate from septic shock at the hospital from approximately 50 per cent to under six per cent.
“Septic shock is a devastating complication of any infection and is the single greatest killer of patients in Australia today,” Professor Smith said. “It is increasing in frequency in the western world, kills young and old indiscriminately, is a bigger threat to life than bowel, breast, and lung cancer combined, and last year killed more Australians than heart attacks.”
In Germany the number of septic shock cases is about 275 000 per year, in the UK about 210 000, in France around 250 000, and is anticipated to exceed a million cases in the USA next year. Sepsis occurs in one to two per cent of all hospitalisations, is responsible for up to 25 per cent of all intensive care unit admissions, and affects over 18 million people worldwide annually.
“Research shows that it is essential to diagnose the condition and treat it rapidly, as mortality rockets in the first few hours and if untreated after four to five hours, 50 per cent of patients will die,” Professor Smith said.
“Worldwide there have been many treatment guidelines designed to reduce the incidence of sepsis and improve its management, but results have remained disappointing. Our team has combined international best practice with the non-invasive Australian technology and developed methods to improve standards of septic shock management that are now being recognised and adopted around the world. These methods save lives, and every hospital in Australia can and should adopt them.
“For a relatively small hospital in rural/regional NSW to achieve this result is rather like the local soccer team beating Brazil in the World Cup, or a learner driver taking the chequered flag in the Bathurst 1000 V8 Supercar Race,” Professor Smith joked.
CSU researcher and Senior Lecturer Ms Veronica Madigan, said, "About one and half million children die from sepsis every year, and we aim to cut that by 10 per cent per year for the next 10 years. This may be difficult, but some of the greatest paediatricians in the world have now joined us and we are confident that it can be done."
Mr Rob Phillips, Director of Science at Sydney-based USCOM Ltd said Professor Smith and his team have demonstrated that septic shock is a curable disease, and their reduction of septic shock mortality by 90 per cent heralds a major shift in clinical practice. “The Bathurst/USCOM protocol set new standards of world practice and it is now being exported to the most highly respected medical centres in the US, Europe, South America and Asia. The potential benefits are inestimable," Mr Phillips said.
NSW Health has now adopted many of the techniques and methods introduced in Bathurst over the last five years to identify and treat septic patients. Members of the Bathurst team have been invited to present their research internationally. Following the World Congress of Paediatric Intensive Care in Australia last year, two international multi-hospital clinical trials have been initiated to advance the Bathurst/USCOM approach to the treatment of septic shock in children. Clinicians from Bathurst will pass on their advanced skills at a series of workshops around the world, starting next week in Hong Kong for delegates from China, South-East Asia, India, Nepal and Russia. Further workshops are planned for Asia in November, and Europe, the United States and Canada in 2013.