27 Jul 2021
Dr. Ron Daniels, Executive Director and Founder of the UK Sepsis Trust, discusses the four ways the UK Sepsis Trust looks to help improve outcomes from sepsis and patient care after diagnosis. Daniels explains the importance of using big data to discover sepsis trends within the population and highlights the benefits of using procalcitonin as a biomarker for pathogen identification within these patients.
My name's Dr. Ron Daniels. I'm an intensive care consultant at University Hospitals Birmingham NHS Foundation Trust. I'm also founder and executive director of The UK Sepsis Trust as well as vice president of the Global Sepsis Alliance.
The UK Sepsis Trust's mission is to improve outcomes from sepsis in terms of saving lives but also improving the quality of life of survivors, and we do this in four ways. The first way is through providing support to people affected by sepsis. We have nurses running helplines and, outside the pandemic, face-to-face support groups 24/7. The second way is improving public awareness so that members of the public have heard of sepsis, and they're empowered to act if they're worried about themselves or a loved one deteriorating with an infection. Of course, we need to make sure that the health-care system is able to deliver their part. So, the third approach is through the provision of clinical tools and education for health professionals. The fourth is, of course, through affecting systems change through lobbying.
The global burden of sepsis is horrific. In 2020, the Institute for Health Metrics Evaluation identified that sepsis affects 49 million people around the world accounting for 11 million lives lost. To put that into context, at the time of recording with COVID-19 having claimed just over 3 million lives worldwide, every single year sepsis (as a consequence of infection) claims a huge number of lives. Disproportionately affected are children in low and middle-income countries. So, those of us working in developed countries have a responsibility to apply systems changes in our countries to learn lessons from that and to use these to help people struggling to deliver care in LMICs.
One of the biggest challenges affecting the way we diagnose and manage sepsis is the fact that we apply a one-size-fits-all definition. We apply an international consensus definition. It is the best we've got, but it applies at the same thresholds, whether we're an 18-year-old athlete or an 88-year-old with cardiorespiratory disease, and it's illogical. We need to better understand how we can customize care for sepsis, identify which patients need antimicrobials urgently, and in which patients it might be safe to wait a little longer and gather more information. The only way we're going to do that is through the use of big data and intelligent analysis of that data, looking for patterns that enable us to identify which patient, at which age, with which comorbidities needs urgent assessment and which ones might not.
We in the sepsis community, among health professionals around the world and in the UK, have been well aware of Thermo Fisher Scientific's responsible approach in the sepsis and AMR spaces for some years now. Thermo Fisher has directly supported activities globally, through the Global Sepsis Alliance and also in the UK, for example, through support for the All-Party Parliamentary Group on Sepsis.
In terms of Thermo Fisher's portfolio, there's huge opportunities in the pathogen identifications base, but one example right now that has really hit home and really come to the fore in the UK among health professionals is the use of the biomarker procalcitonin. It was rarely used prior to COVID-19, and now it's an almost routine use in intensive care units because it's a great help to allow us to determine which patients with COVID-19 also need antibiotic therapy.
In terms of the future of sepsis management, I think the biggest win is to be able to customize care. The biggest win has to be around more intelligent use of antimicrobials and more intelligent ability to deliver healthcare in the right setting at the right time. We can't do that through a single consensus definition. We can only do that through learning. There are vast swathes of data collected in health-care systems around people's diagnosis, their laboratory data, their vital signs data, but also the symptoms and the signs that they're reporting to health professionals. If we can collate all of those data, analyze them interoperably, intelligently, look for patterns, we can start to understand which patients need hospital assessment, which patients need antibiotics now, and in which patient we might be able to wait for a little while.
UK Sepsis Trust
Ron Daniels is an NHS Consultant in Intensive Care, based in Birmingham, U.K. He’s also Executive Director of the UK Sepsis Trust and is Vice President of the Global Sepsis Alliance. In 2016, he was awarded the British Empire Medal for services to patients. Ron’s expertise lies in translational medicine and leadership. He leads the team driving dissemination of the Sepsis 6 treatment pathway and is part of the team responsible for much of the policy and media engagement around sepsis in the U.K. and elsewhere, including the adoption of the 2017 Resolution on Sepsis by the WHO. At home, Ron’s worked with the NHS over the past five years to ensure that, in England, more than 80% of patients presenting with suspected sepsis now receive appropriate antimicrobials rapidly. He’s ever mindful of the perceived conflict, and the synergies and need for collaboration, with the antimicrobial stewardship agenda.