Sepsis, Richard, Fever discussed on Short Wave
You're listening to shortwave from NPR. Mattie Safai in the House with Richard Harris yet another one of my favorite science correspondence must be all your favorite special. That's what my mother always said. You're all my favorite Richard. You have some serious business to discuss today. Indeed indeed I do yes. I'm GonNa Talk to you about sepsis right so for anybody who might not know. Sepsis is actually caused by the body's reaction to an infection basically the immune system overreacts causing this huge inflammatory response. Blood vessels get a leaky which messes up. How blood flows throughout the body body? In severe cases. Septic shock can set in. And that's when your blood pressure drops to dangerously low levels sometimes leading to multiple organ failure and in death doctors treat that initial infection and they can try to manage the dangerous symptoms of Sepsis. But there's no cure for it that's right and as a result assault is the single most expensive condition in. US hospitals best estimate is that it strikes one point seven million people a year in the United States and kills more than a quarter million. Wow so it's a huge toll right and one of the reasons. It's so common is because a lot of different types of infections can result in sepsis many roads into sepsis but even though it's a huge deal we don't really talk about it that much in. That's kind of weird isn't it is such a common condition but it isn't even bigger problem. Globally thirty thousand people die of it every single day. That's why it's a huge number. It's truly under appreciated disease. And why I'm telling you the story today is because the results have been published important new study on the treatment of Sepsis with the transfusion of simple mixture really vitamin C.. And Fireman thion which is vitamin B. One that's right and also some corticosteroids. These are all cheap and readily available drugs so today in the show the journey to find a cure for sepsis. Yes we hear the latest on this wild claim about a potential cure of vitamin C drug cocktail. Okay Okay Richard. When you were first telling me about this you said you actually got to talk to somebody a few years ago? Who received this newfangled treatment right? I was interested in really following how this evolved volve this this audacious idea and seeing where it would go and actually a number of doctors immediately started picking up and started using it at least on their most desperately ill patients and talked to one of them. This guy with an incredible story in Christopher Kelly who had this horrid logging accident this is out in Seattle I was cutting for a logging outfit up on these rock cliffs and fell about one hundred and fifty foot for tree into these maple trees. They add a bunch of dead tops we call them widow makers mhm tree came down the butt of it bounce toward him crushing him. I heard the bones crunch when it got me. It was pretty precarity Yell for a minute. And then I'd pass out and I guess my ribs were ripping. My lungs is the reason I I was only you know in and out of consciousness. And Amazingly he was there for a couple of hours before a couple of other men working in the area found him and got him on a Medevac helicopter to harborview medical center in Seattle in the Wendy says he wound up with a shattered pelvis all of his ribs. Broken twenty two bones and Dane. The day I met him. He developed a very high fever along with shock. That's one of Kelly's doctors at David car-bomb who realized that Sepsis was beginning to set in so sepsis is one of the big risks and injuries like this because infections sometimes time start on the wounds on the skin or from inside the lungs or internal injuries or whatever and the infection of course can turn into septic shock which is the nastiest form of this condition. When Oregon's start to fail that often leads to death and as we mentioned earlier? There's no known cure for SEPSIS. That's right car-bomb could treat the underlying infection with antibiotics Roddick's but he was also one of a set of doctors who had actually started experimenting with his new treatment of vitamin C and firemen and steroids and discuss it with his son and his son and was very amenable. We talked about The fact that it's a new therapy that there really wasn't very strong evidence but I felt that it was not a ton of risk and that this could be beneficial. How did it work Richard? Well hold on how quickly to respond. Usually patients very sick for a few days before responding antibiotics and him it took about a day his fever head cleared and he was off the medicines to support his blood pressure and looked remarkably better. But this is not actually a totally new new idea at all. I mean vitamin CS. Curative Properties have been batted around for decades and decades. A lot of. It's kind of Kooky so that actually works against this argument people initially and understandably skeptical about it but that said it is true that people who have sepsis have surprisingly low levels of vitamin C in their blood. So there's some biological logical plausibility to doing this right. Carbon himself was still on the fence about whether this was really the real deal but other doctors had also also had similar stories to tell and in fact car-bomb decided to try the treatment after reading about it in a report by this well-known critical care. Doctor named Paul Merrick Acoust- eastern Virginia Medical School in Norfolk Virginia morning actually went down to visit him in his intensive care unit back in twenty eighteen so I could see for myself and learn more about outs. This anyone's really frustrating. Because you know I would round and see this and say this is really cool and I would submit it for publication and people would pooh-pooh amy so miracles. The guy who came up with this idea of combining vitamin C. and time and steroids along with a standard treatment for sepsis fortunately a new Richardo and kind of open minded person and chance and he said looking chest is the journal where this was published and the results republished. Her kind of unorthodoxy looked at forty seven patients. He treated one after another in this way and then he compared it to forty seven other patients. who had been treated before he came up with this idea idea and Of the forty seven patients were treated only four had died and none of them had died of sepsis and of the previous forty seven patients. Nineteen died in the hospital so so if he was thinking. Wow this is my day so the next says you know they say this. Is You know snake oil and ferry dust and all kinds of the things but if you actually see it I mean issues remarkable. This ended. The tragedy is that the people who should be interested in this. Even if you skeptical just keep an open mind because people have steps is every single day and you know we turn these people around and so he's pretty convinced at this point. Yes so it's working good for him so he believes that but he understands why there's a lot of skepticism about their because this is an unconventional way of trying to test. Whether something works or not right in theory you'd want like a clinical trial l.. With lots of control groups placebos all that good stuff right and there's another thing right people have said that they've come up with a cure for sepsis before release good treatment. Supposedly there was a drug that was actually approved to treat sepsis but then on further examination they decided that didn't work and actually pulled off the market so this has been an area of huge the frustration over the years. Okay so in order to know if it really could be a cure we need clinical trials right so tell me where we are with us so doctors around the world of actually launched dozens of studies to look at this. The designs vary a lot but some of them are actually pretty careful studies where they randomly selected patients to other get the treatment or to get a placebo. You you love to see it Richard. The gold standard is here here. We go keep going. That's it that's it and these studies have been done across multiple to some tests were coordinated out of Harvard. Some of emory university. Johns Hopkins Anyway A lot of these launched in two thousand eighteen and They're pretty much all still in progress or they finished collecting their data and they're still figuring it out and having published the results yet right but there was that one study that has recently published. Its results right. What did they find right so? This was an Australian study. It was based on two hundred patients and they were in hospitals in Australia and New Zealand and also in Brazil they announce their results a few weeks ago and for them. Vitamin C.. Treatment was a total bust. No yes alas. I talked to Dr Renaldo below in Melbourne Australia. He told me he understands why. There's enthusiasm for the vitamin C.. Treatment given the dismal history of trying to find an effective treatment for sepsis people latch onto promising interventions because because of that frustration. And it's understandable Bought you know the view from here is that we shouldn't substitute The hope for evidence he actually led the study and a colleague of his presented the results in mid-january in Belfast Northern Ireland in the Conference Center called the Titanic Hanoch honestly. Richard Titanic is a weird thing to name a conference center but fine. Yeah Paul Merrick. Thought it was a weird thing to and sort of an omen for him because he was actually at at the conference when things turned south for him. And that's the guy that came up with the original idea for the sepsis treatment that's right and his biggest complaint actually is that the study didn't treat people right away. It was an average of twelve hours after they checked into the ICU. I don't even know how long before that people are sick and suffering from sepsis so Merrick says you know as soon as my patient shop in the emergency room I treat them right away and he believes that if you wait more than even six hours It's too late so he thinks that's why had this trial failed. And he says he still uses it every day. He's treated fifteen hundred patients so far and he still says he believes he saving lives every day. So what does this mean for the future future of sepsis treatment. Is it just still a big question. Mark kind of unfortunately still a big question. Mark the ultimate lesson here for one thing. Is that no single. Study is definitive. In this case everyone agrees with cliche. That more research is needed science. Your has a way of making us. Wait how Richard. Unfortunately it does Yep but unfortunately these studies are quite far along and we should be getting results from them in the coming months or maybe by the end of the year. I hope at least by then so we'll just have to wait and see for now. I can say this vitamin C.. Infusion is not an accepted treatment but there are still some doctors who use it and say.