Final Revised_Septicemia_Leonard

septicemia, novel enzyme markers and identification of septic shop Brett

Powell and Jessica Leonard.

Mhm. Alrighty.

So in this presentation we're gonna summarize our presentation on

septicemia. So as you can see here, sepsis comprises approximately

30% of our icu patients.

There are several things that categorize septicemia, such as multi

organ dysfunction, leaky vessel syndrome and bacterial agents in the

blood. Um We have some tests that we can do

for this right now.

D. P.

P. Four and P.

R. C.

P. Along with our fibroblast activation activation protein and prep

are our primary exams for this.

The enzymes are released by the immune system in response

to the onslaught from the bacteria.

So here we see our strengths, weaknesses, opportunities and threats.

So on some of our strengths uh we are actually

pretty good at implementing substance screaming.

Uh We do have a surviving substance campaign that was

performed by multiple drug manufacturers that outlines the critical treatments

weaknesses. Sepsis does still slip by us a fair amount

and there are a lot of avenues for substance to

occur, especially in healthcare setting.

And most adults are unaware of sepsis.

As far as opportunities.

We can reduce the number of deaths from sepsis by

earlier condition.

We can fast we can act faster if we can

detect it faster and we have a policy created um

threats, patients are always in an increased threat from foley

catheters, indwelling lines, stuff like that.

Um Central lines are a very big source of it.

That's why we do them under sterile technique.

So we've now moved onto methodology as far as our

timeline goes, substance can present quick or slow.

It's always started by a source of infection where the

blood enters the bacteria.

Uh These organisms give off nitric oxide, it opens up

our blood vessels causing leaking and basal dilation.

This progresses to organ dysfunction.

And as the organs fail one by one, invariably will

end up with death if we don't treat this and

intervene in a timely manner.

So here we uh look at a research study conducted

in the Netherlands, patients were divided into three groups based

on the definition of septic shock.

They have uh they had to meet two or more

of the serious criteria which is systemic inflammatory response syndrome

and the need for blood pressure support.

One group was 30 healthy adult controls.

So obviously So our 30 healthy adults obviously we're not

septic. We then got 22 patients in the icu.

That we're not septic.

And 40 patients that met the criteria.

Um All these patients were located in the neuro ICU

after surgery.

Uh They were not traumatic simply because trauma is a

very big vector for sepsis and usually the trauma protocol

is going to be a gram of answer if prior

to any sort of treatment or testing.

So also with trauma, our metabolism ramps up a lot

and that of course cues are enzyme activity.

So our timeline uh in this study blood was taken

from each group 135 and seven days from arterial source

and ran through E.

D. T.

A. And lithium heparin tubes.

These are found commonly in almost every hospital.

Uh There's interviews, they separate out the plasma and store

the plasma for further analysis for the study.

Each enzyme used their own specific essays to determine the

activity levels and the presence of those enzymes.

Once the enzyme activity was calculated for each test results

were plotted by comparing enzyme activity versus the day collected

Findings from the study, uh we ended up having about

43% rate of pneumonia and 25% of abdominal sepsis.

Uh pneumonia is definitely one of the most critical things

that we deal with and it's very common.

Um These correlate across not only the U.

S. But almost the entire planet as far as what

we have.

Um There are some of the things that we can

do so we can protect the lungs on ventilators.

We can uh use Visa pressures to help keep our

blood pressures up and we can use sterile techniques for

all of our indwelling catheters and lines.

And we can also get really early in the game

on antibiotics, plasma activity.

We didn't find a statistical difference between the ICU control

and healthy individual control groups.

P. R.

C. P.

Was shown to be higher in septic shock patients as

well as the prep enzyme compared to the ICU control

which is to be expected with sepsis.

Mhm. Uh So our rock.

Um Our area under the curve as you can see

here F.

A. P.

D. D.

D. P.

P. Four was 0.94 and the prep was one.

Um We found that the F.

A. P.

And prep combination was extremely accurate to test for enzyme

activity in septic shock.

Um Could be an optimistic value.

It needs further study though.

Um for their analysis uh We couldn't really find any

further associations between certain enzymes and other frequently managed measured

parameters for sepsis.

So we come to our analysis yeah we found a

strong correlation between the specific enzymes and septic shock.

However it's not necessary.

It's not necessarily specific for sepsis.

Uh Sepsis.

Um DPP four lovers are also lower in patients with

rheumatoid arthritis and cancers.

And that's because certain medications we use drive those levels

down um in the future hopefully pro calcitonin is going

to be the front runner for sepsis.

Some facilities are using this however, it is not adapted

by you see yet.

So here you see our current substance parameters.

Um The specificity of these enzymes is not present.

Um Sepsis is kind of a gray area as well.

There's no one specific biomarker that says this patient septic.

Yes or no.

It's a combining of a lot of different factors coming

into it.

Um There is a strong association with these enzymes but

like I said it's not entirely accurate.

So here we see all of our lab value normal

ranges along with our changes in sepsis.

However, all these could be skewed one way or the

other depending on the bacteria use the patient's physiology, environment

time we get them and their path of physiology for

whatever medication they're on.

So or what if as far as test for sepsis.

So um enzymes are already testable with the technology we

have and they're relatively cost effective.

However, that can always be improved.

We can also do further enzyme research to determine if

there's any more that we can use and compare what

we see with long term sepsis care versus what enzymes

are early.

And another thing we can do is we can make

the test more portable.

So if we can get him to our pre hospital

providers are paramedics are MTs and our ambulances helicopters.

We can really identify sepsis early in the field.

Start treatment and get these patients better faster.

So conclusion.

Skepticism. Multifaceted multi system infection most commonly caused by a

microorganism. Okay, bacteria, DPP four P R.

C. P.

F. A.

P. And prep enzyme activity have been proven to be

dis regulated in patients with diagnosis, septic shock compared to

the ICU control group used in tandem with other standardized

parameters and the diagnosis of sepsis.

It is possible that a much more efficient test for

sepsis or patients is likely developed can be created to

allow for a better prognosis and much more rapid onset

of necessary in life saving treatment And here are the

references we used in creating our paper.

Final Revised_Septicemia_Leonard_Powell

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