Cooper Participates In Pivotal Sepsis Study

PRLog (Press Release) - Feb 25, 2010 -
COOPER PARTICIPATES IN PIVOTAL SEPSIS STUDY
Highlighted in This Weeks’s Journal of the American Medical Association (JAMA)

Camden, N.J.—Sepsis, a bloodstream infection that causes a patient to become critically ill, claims more than 200,000 lives every year in the United States alone. In the most severe form of sepsis, a patient’s blood pressure suddenly drops to dangerously low levels and major organs in the body start to shut down, putting the patient at high risk of death. In treating these patients, time is of the essence. Cooper University Hospital, as part of the Emergency Medicine Shock Research Network (EMShockNet), was part of a pivotal research study comparing two different methods of guiding early therapy of these severely ill patients in the Emergency Department.

Performing aggressive resuscitation, which may include large volumes of intravenous fluids and various medications to keep the blood pressure from falling or make the heart pump stronger, is known to save lives in patients with sepsis. However, the best methods for monitoring the effectiveness of this treatment were unclear. Prior research suggested that physicians should monitor resuscitation by using a special catheter device that was inserted through the veins in the neck into the heart, which continuously monitored the oxygen level in the blood. However, most hospitals do not have the capability to perform this type of technologically-advanced care in the Emergency Department. As a result, many critically ill patients across the country are not being considered for this type of therapy. A more simple method was needed.

In the new treatment strategy under investigation termed “lactate clearance”, resuscitation was continued until lactic acid (which can build up in high levels in sepsis) was cleared from the blood. Lactic acid is relatively simple to measure by routine blood test in most hospitals. In this study of 300 patients with sepsis, the mortality rate was 17 percent with a lactate clearance strategy versus 23 percent with oxygen level monitoring. Under the direction of Alan Jones, M.D., lead author and a physician at Carolinas Medical Center in Charlotte, N.C., the study demonstrates that monitoring lactate clearance is an equally effective method to guide early therapy for patients with sepsis.  

Stephen W. Trzeciak, M.D., M.P.H., a co-author and physician in critical care and emergency medicine at Cooper added, “We hope that more hospitals across the country will now be able to perform this type of aggressive resuscitation and in turn more patients can benefit.” Cooper, Carolinas Medical Center, and Beth Israel Deaconess Medical Center in Boston, Mass., were the only sites in the country to participate in this two-year study sponsored by the National Institutes of Health.
The study appears in the February 24 issue of the Journal of the American Medical Association.