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Sepsis: Beyond the boundaries of fatality, enhancing clinical skills and precision medicine

Sepsis is a clinical syndrome with a distinctive response of the body’s defenses to life-threatening infections. This may result in organ dysfunction or failure (severe sepsis). Sepsis is strongly related with all the body organs or systemic diseases and to the quality of the best-practice in use, particularly critical  in surgical or  intervention techniques. In this view, apart the clinical risk analysis and management of the entire process of care, the techniques used, and the personal skills of the health professionals, with the quality of the equipment supply, the actual factors that may  be easily unseen. The quest for bio-markers consistent with the unmet needs of medical doctors and of their patient and the efforts for overcoming bacterial antibiotic resistances are currently the main efforts of the medical research.

Research and innovation should take advantage from greater knowledge and skills in bioinformatics. The European Medical Association, a partner of HFE, is actively involved in the development and dissemination of the Erasmus Plus BioS Project, aimed at the increase of competence of European health professionals in bioinformatics and related fields. The caveats related to in-silico approaches must be flagged: algorithms may equally warrant scientific innovations or hide the lack of it; a patient is more than a set of covariates.

Recommendations. Epidemiology and prevention includes all the actions suitable for an adequate hygiene and immunization of all populations and for safer procedural pathways during any hospital stay. The most unresolved critical points in sepsis are early and timely diagnosis; both currently impaired by low degrees of suspicion for the possibility of emerging sepsis, by the shortage of use of the simplest microbiological testing but, equally or more, by the insufficient diffusion of non-invasive imaging skills suitable to detect and monitor the emerging sites and sources of infection. In primary care, in emergency facilities, in hospital wards and in intensive care units the inclusion of appropriate knowledge, skills, expertise and imaging equipment must be extended as much as possible. The very low cost of Ultrasound machines makes this investment affordable even in limited-resources context. The counterpart of this effective development is the need of providing high quality and lasting educational support in diagnostic and intervention ultrasound procedures, including echocardiography.

A realistic perception of disease, for enhancing resilience of patients and health professionals,  is the basis for a strong agreement and alliance of doctors and patients against diseases, which have many concealed effects. Support of patients with such severe diseases should not be only “consolatory” for accepting “fatality”, because such interventions may hidden the real needs and the quest for most appropriate potentially available expertise.

G. Trovato EMA

Guglielmo Trovato 
EMA– European Medical Association