Research into sepsis, which is the leading cause of death among children world-wide, has helped doctors at Apollo Children’s Hospital develop a set of protocols to treat the condition with precision and help save lives.
Addressing the media on Wednesday, Suchitra Ranjit, head of the paediatric ICU at the hospital, explained that sepsis could start ordinarily as a childhood fever but that within hours or days, septic shock could turn deadly. “It is an under-the-radar, silent killer. Our immune system can actively work against the body when sepsis sets in, and early diagnosis is crucial to a good result. In Indian hospitals, the death rate from sepsis is between 20 and 50%,” she said.
In her research, Dr. Ranjit found that sometimes children treated with standard septic shock protocols, which broad-spectrum antibiotics, oxygen and a large volume of fluids, did not respond well. “One size does not fit all. Over-treatment or under-treatment can lead to multi-organ failure and death. We use multi-modal monitoring to find out exactly where the problem lies, and target it with precision therapy. This means giving the exact volume of fluids required, as too much can flood the lungs and too little can affect the kidneys. We also find out what the problems in the heart are — whether it is sluggish or on overdrive, and give medications accordingly. We also give medications to regulate the blood vessel tone,” she said.
In three cases at the hospital recently, the multi-modal monitoring and precision therapy saved the children’s lives, she said. One of these, was 16-year-old Sankey Samuel, who fell ill, developed a skin infection and came to the hospital with septic shock, in August last year. Now though, he is completely back to normal, pursuing his passion in singing and will soon enter class XII.
The hospital’s septic shock mortality rate is 8 to 9 %.
“Emergency room doctors must always think about sepsis and parents too, should not delay treatment,” said Dr. Ranjit. Some of the signs that a fever was sepsis, were: an abnormally fast heart rate, the child not feeding, a change in the child’s mental status and cold extremities, she said.
Indira Jayakumar, senior consultant, paediatric ICU, and Preetha Reddy, executive vice chairperson also participated.
