A near-miraculous treatment for acute sepsis needs help with further validation

Can health tech help? Sepsis, according to the CDC, is “a complication caused by the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death.” It often happens when another underlying condition is occurring, but which cannot be located, but the sepsis is overwhelming and must be treated first. The sepsis has to be treated quickly, or else the patient winds up being a statistic, or worse, disabled or dead. The UK Sepsis Trust estimates 37,000 annual deaths (derived from an extrapolated dataset provided to the UK Sepsis Trust by the Intensive Care National Audit and Research Centre (ICNARC) in 2006) with an estimated 200,000 cases per year. In the US, the estimate is over a million cases a year (NIH). Worldwide, it may be 15-19 million cases. The odds are that sepsis may have touched you, a family member, friend or someone you know. (For this Editor, two in the past six months–and one did not make it.)

There may be a treatment that is both effective and cost-effective, a combination that is hard to beat. It was developed on the ICU front lines at Sentara Norfolk General Hospital (Norfolk General), located in Norfolk, Virginia. An ICU physician, Dr. Paul Marik, who is also chief of pulmonary and critical care at Eastern Virginia Medical School, had read journal articles on treating sepsis with IV infusions of vitamin C. For a patient sinking fast, to the vitamin C infusion he added hydrocortisone to bring down inflammation. The desperately ill patient recovered and within three days left the ICU. The treatment was repeated in other sepsis patients, adding thiamine (vitamin B1). In 2016, Dr. Marik and others from Sentara, Eastern Virginia Medical School and Old Dominion University published their study of the protocol in CHEST Journal (American College of Chest Physicians). In a seven-month period prior to the new protocol in 2015, 19 of 47 septic patients at Norfolk General died–40 percent. In 2016, with the new vitamin C-hydrocortisone-thiamine treatment in place, in a comparable seven-month period, 4 of 47 died–8 percent–and the four deaths were attributed to the underlying condition.

Now here is a challenge for those of us in health tech. It needs a comprehensive study. There are no miracle drugs here but a ‘miracle’ in treatment. According to the article, Stanford University is interested. Drug companies are not going to be–this treatment costs under $100 and there’s nothing patentable. Virginian-Pilot (Hampton Roads-Virginia Beach)

One–can we get the word out and interest a university or big hospital?–and two, can we find a way to use technology to prove the case in a biological way? Should this be studied outside the US?  Also For the Record in a 2014 article indicates that the sepsis numbers, if anything, may be understated for various reasons. Sepsis is a ‘hot button’ issue for hospitals and physicians. Hat tip to former colleague Colleen Matthews via LinkedIn  

Related reading: Guest Editor Sarianne Gruber’s article in RCM Answers from last September’s Sepsis Awareness Month, about the Sepsis Alliance and WPC Healthcare.

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