'Care bundles' cure for sepsis: Study

NEW DELHI: It doesn't take the best hospital or costly therapies to save a patient suffering from sepsis - a potentially fatal condition which causes release of toxins in the body. Team approach and goal-directed therapy can save many. A multi-centre study conducted on 556 sepsis patients in eight hospitals across Asia, including two Delhi hospitals has shown this.

It bears huge significance for Indian hospitals where number of deaths due to sepsis on account of poor infection control, antibiotic resistance and other risk factors like diabetes and chronic kidney disease has been on a rise, say the doctors. According to Dr Sumit Ray, vice-chairperson, critical care medicine at Sir Ganga Ram hospital which participated in the study, mortality rate reduced from over 53% to 26% in sepsis patients with the implementation of the targeted therapy also known as "care bundles".

"In this therapy, we try to identify the high risk patients at the earliest and administer antibiotics, fluid resuscitation and transfusion of red blood cells in appropriate measures within six hours of diagnosis," said Ray. He said in the experimental model, treatment is taken over by the critical care management team as soon as a patient is diagnosed with sepsis as against the traditional approach where patient is managed in the emergency ward before being shifted to the ICU for critical care.

Dr D S Rana, chairman of Sir Ganga Ram hospital, said the bundle therapy is not expensive and can be implemented in any secondary level hospital. "Our study shows that implementation of the new model is best when doctors work as a team," Rana said.

The eight hospitals which participated in the trial termed as ATLAS (Asia Network To Regulate Sepsis) are Severence hospital in Korea, SGRH, Fortis hospital and Apollo health City in India, Chang-Gung Memorial hospital and National Taiwan University hospital in Taiwan and Raujin hospital, China. While three of them followed team model, the rest followed non-team model. According to a study published in the International Journal for Quality in Health Care, the implementation of the bundle therapy increased from 37.5% to 88.2% with team approach. With non-team approach, compliance rate was from 5.2 to 39.5%.

Dr M C Misra, chief the AIIMS Trauma Centre said, "A uniform guideline for treatment of such cases is important. Many times, patients are administered heavy doses of antibiotic therapy which proves detrimental in recovery."

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