Episode 107 Sepsis: It’s a mess

Over the years of the podcast, we have often struggled with questions of why: why pathogens act the way they do, why certain people get sick while others don’t, or why we know little about some diseases. This episode is no exception – sepsis certainly inspires many “whys”. But for perhaps the first time on the pod, we find ourselves grappling not only with “why?” but also with “what?”. What, indeed, is sepsis? Ask a dozen doctors and you may get a dozen different answers. Our first goal for this episode is to sift through the various definitions of sepsis and what we know about its pathology to get a firm handle on this deadly consequence of infection. We then turn our sights to a thrilling period of sepsis history – Joseph Lister and his carbolic acid spray – before attempting to address the status of sepsis around the world today. By the end of the episode, your picture of sepsis may not be crystal clear, but hopefully the edges are a little less blurry.

And helping us to de-blur the edges of sepsis is the wonderful Katy Grainger, leading sepsis and amputee advocate and on the Board of Directors of Sepsis Alliance, who shares with us her harrowing sepsis experience. You can learn more about Katy’s story and advocacy work by following her on instagram (@katysepsisamputee), TikTok (@katysepsisamputee), Facebook, or by checking out www.sepsis.org.

HistoryBiology
Fitzharris, Lindsey. The butchering art: Joseph Lister’s quest to transform the grisly world of Victorian medicine. Scientific American/Farrar, Straus and Giroux, 2017.Gyawali, B., Ramakrishna, K. and Dhamoon, A.S., 2019. Sepsis: The evolution in definition, pathophysiology, and management. SAGE open medicine, 7, p.2050312119835043.
Botero, Johan Sebastián Hernández, and María Cristina Florián Pérez. “The history of sepsis from ancient Egypt to the XIX century.” Sepsis-an ongoing and significant challenge. Intechopen, 2012.Cecconi, M., Evans, L., Levy, M. and Rhodes, A., 2018. Sepsis and septic shock. The Lancet, 392(10141), pp.75-87.
Funk, Duane J., Joseph E. Parrillo, and Anand Kumar. “Sepsis and septic shock: a history.” Critical care clinics 25.1 (2009): 83-101.Rubio, I., Osuchowski, M.F., Shankar-Hari, M., Skirecki, T., Winkler, M.S., Lachmann, G., La Rosée, P., Monneret, G., Venet, F., Bauer, M. and Brunkhorst, F.M., 2019. Current gaps in sepsis immunology: new opportunities for translational research. The Lancet Infectious Diseases, 19(12), pp.e422-e436.
Noah, Zehava L. “The history of sepsis management over the last 30 years.” Clinical Pediatric Emergency Medicine 15.2 (2014): 116-119.Lin, G.L., McGinley, J.P., Drysdale, S.B. and Pollard, A.J., 2018. Epidemiology and immune pathogenesis of viral sepsis. Frontiers in immunology, 9, p.2147.
Vincent, Jean-Louis, and Edward Abraham. “The last 100 years of sepsis.” American journal of respiratory and critical care medicine 173.3 (2006): 256-263.Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C.M., French, C., Machado, F.R., Mcintyre, L., Ostermann, M., Prescott, H.C. and Schorr, C., 2021. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive care medicine, 47(11), pp.1181-1247.
WHO Sepsis Fact Sheet: https://www.who.int/news-room/fact-sheets/detail/sepsisendoto

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