Alexander CookA recent paper co-written by Fernando Godinho Zampieri, a University of Alberta assistant professor in the faculty of medicine and dentistry, aims to give a full overview for general hospitalists on how to treat sepsis with intravenous (IV) fluids.
Zampieri co-authored the paper with Dr. Sean Bagshaw, a U of A professor in the faculty of medicine and dentistry, and Dr. Matthew Semler, an assistant professor of medicine at Vanderbilt University Medical Center.
“We hope that a person that is not familiarized with sepsis will find this article [to be] a good reference,” Zampieri says
Zampieri explained that sepsis is a common and deadly disease that affects people worldwide. Additionally, up to one-third of critically ill patients in intensive care units (ICU) are affected by sepsis.
Zampieri has personal experience treating the disease, as he has trained and worked in the ICU.
“Sepsis is a severe disease that occurs when you have an infection. That infection triggers a severe inflammatory response in the body that can damage the organs,” Zampieri said.
He added that sepsis can cause damage and failure in organs that were unharmed by the original infection.
A common way of treating sepsis is with IV fluids. This is the “administration of a fluid solution directly through the patient’s vein,” Zampieri said.
“It’s a life saving intervention that can help increase blood pressure, improve blood flow in the body, and potentially prevent or reduce organ failure in those patients.”
Although treating sepsis with IV fluids is a common intervention, physicians may be unclear on the specifics, according to Zampieri.
“There are many unknowns on how much fluid you should give, when you should give it, when you should stop giving it, and how you should give fluids.”
Zampieri wrote the article to help make the specifics of treating sepsis clearer. He hopes physicians will become more comfortable with administering the treatment as a result. Zampieri noted that some physicians encounter the disease a lot more frequently, such as specialists or those in the ICU.
“We hope that a person that is not familiarized with sepsis will find this article [to be] a good reference on how to manage sepsis,” he said.
“We want the field to boom so that new research comes and mortality for those patients decreases”
Zampieri said that to treat sepsis effectively, the physician first needs to diagnose and treat the source of the infection.
“The first things the clinician should do when they suspect that there is sepsis is actually finding the source, controlling the source, and giving antibiotics,” Zampieri said. “Fluids will not treat sepsis by themselves.”
Most importantly, as patients receive fluids they need to be frequently reassessed to understand how they are responding to the treatment, Zampieri said. This includes checking that the patient is not receiving too much fluid, which can cause complications.
Zampieri noted that mortality due to sepsis has been declining on a global scale. He believes this trend will continue, although sepsis “will never disappear because infection has been with mankind since inception.”
He believes more research is still necessary, especially for populations that are often not included in clinical trials. This includes children, pregnant people, and those with neglected tropical diseases.
“We should better understand the particularities or the differences among sepsis sources and how we can tailor therapy for the clinicians for a specific patient.”
Zampieri has been involved in a number of clinical trials before and during COVID-19. He has plans to study the difference between IV fluid types. He also plans to study the best ways to remove fluids after use.
“We learned a lot during COVID-19. I believe that we are now designing better clinical trials and trials that will provide better answers.”
Zampieri hopes that the article will become “obsolete” as further research is done and advances are made.
“We want the field to boom so that new research comes and mortality for those patients decreases.”
