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Science AMA Series: I’m Dr. Steven Q. Simpson, a pulmonologist, intensivist, member of the board of the American College of Chest Physicians and a sepsis researcher and expert. AMA!
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My name is Dr. Steven Q. Simpson. I’m a Professor of Medicine and Interim Director of the Division of Pulmonary and Critical Care Medicine at the University of Kansas. As a sepsis and quality improvement researcher and educator, I’ve spent decades training hospital providers across the country to aggressively treat sepsis in all its forms. I’m also a member of the board of the American College of Chest Physicians, an organization representing 19,000+ clinicians practicing pulmonary, critical care and sleep medicine. Sepsis is the body’s response to a life-threatening infection, most commonly caused by a bacterial infection, but it can also be caused by serious fungal or viral infections. In basic terms, your body goes into overdrive to fight an infection and ends up damaging itself. Sepsis does not just happen on its own, meaning a prior infection—like pneumonia or a urinary tract infection, is present in all cases. Sepsis can lead to tissue damage, organ failure and death in many cases. Sepsis strikes more than a million Americans annually and frequently impacts those who are over age 65 or less than 1 year, have a weakened immune system or chronic medical conditions like diabetes. However, it is not uncommon for normal, healthy adults and children to be affected when a seemingly simple infection progresses to severe sepsis. One of the main challenges of sepsis is diagnosis—often, by the time physicians become aware something is wrong, the disease may be advanced. Sepsis signs and symptoms are not very specific and may at first seem like a simple viral infection, which results in delays in patients seeking medical attention. There is no specific laboratory test that can diagnose sepsis or severe sepsis. Instead, physicians must be astute to recognize the signs and symptoms, recognize the infection and know when the combination is potentially deadly. Early recognition is key to patient survival; delays in delivering relatively simple treatments, such as antibiotics and IV fluids, are associated with increased mortality. Recently, a consensus statement was released that proposes to redefine the diagnostic criteria of sepsis, and that would eliminate the concept of the systemic inflammatory response syndrome (SIRS). The proposed syndrome would rely on known or suspected infection with a change in sequential organ failure assessment (SOFA) score. Shortly after the new guidelines were published, I released my rebuttal in the journal CHEST, New Sepsis Guidelines: A Change We Should Not Make (http://bit.ly/1M8eKYZ), expressing concern that many physicians and specialties have shared—widespread application of this new definition could cost patient lives, and it should not be adopted. Please feel free to ask about anything related to sepsis, critical care, or pulmonary medicine. I will return at 12 p.m. CST to answer your questions. Conflict of Interest Disclosure: My thoughts and opinions are my own. I don’t have financial relationships with anyone—except my wife, who is a pediatric ENT surgeon and gets paid more than me. She takes everything I make, anyway, and makes sure that I don’t spend it all. She gets her sepsis info from me, not vice versa, and she’s pretty good at diagnosing it. For more information on my research: CHEST 2016: Did We Need New Definitions for Sepsis? (http://bit.ly/2if7oW3) YouTube: Surviving Sepsis: The Value of Real Time Surveillance (http://bit.ly/2hV4mWl) I’ll be back at 1 PM EST to answer your questions! AMA!