TMC PULSE

30 T M C » P U L S E | A U G U S T 2 0 1 8 Having the right amount and right type of immune cells and white blood cells is important in the treatment of cancer patients, especially in the event that they can't take antibiotics. The faster sepsis is recognized, the faster the treatment and the better the outcome, Malik reit- erated. If sepsis isn't diagnosed in time, it is likely the patient will be in full-blown shock and, in that case, it is hard to reverse the failure of multiple organs. In addition, the immune system is going wild, attacking at every angle. Malik chairs the Sepsis Committee at MD Anderson, which seeks to improve outcomes for cancer patients with sepsis. She also serves on the steering committee for World Sepsis Day under the auspices of the Global Sepsis Alliance. Locally, she and other care providers also came together to form the TMC Sepsis Collaborative, a multi-institutional effort to galvanize Texas Medical Center institutions in adult and pediatric sepsis care, research and outcomes. "We want to share experiences and learn from others who have developed successful ways of treating sepsis," she said. In addition, MD Anderson's Cancerwise blog includes articles on sepsis protocols, as well as videos to help patients understand sepsis. "We empower patients and caregivers to recognize and say they have sepsis," Malik said. "It jumps the ball forward much faster in the emergency room setting because every minute counts." First hour is critical Timing is critical for the treatment of sepsis, which includes administering antibiotics and intravenous fluids to maintain blood flow and oxygen to different organs. The Surviving Sepsis Campaign, launched in 2002, recommends 3-hour and 6-hour bundles of care—protocols clinicians should implement after a patient presents with symptoms of severe sepsis or septic shock. Those include starting antibiotics within an hour and checking labs for information on kidney, liver and lactate functions within the first three hours. Beyond that, caregivers check for progress on lower blood pressure and increased hydration. If a lactate level rises, the patient is going to have a bad outcome, potentially, Malik said. In 2018, though, the Society of Critical Care Medicine and European Society of Intensive Care Medicine recommended a one-hour bundle of care because the first hour is so critical for sepsis treatment. This shift validated all the work that Velamuri and his team at Luminare have been doing. "It's good to see the industry agree with what we have been saying," Velamuri said. Sepsis is the No. 1 cause of death from infections and it is preventable. We see it in all ages, genders. It hits everyone, and the difficult thing is there is little in the armory to fix it. — IMRANA MALIK, M.D. Associate professor in the Department of Critical Care at MD Anderson Cancer Center • Houston area's only MPH program in healthcare management • One of only !ve MPH programs in healthcare management in the nation accredited by the Commission on Accreditation of Healthcare Management Education (CAHME) • Located in the heart of the Texas Medical Center • Diverse faculty includes researchers, consultants, former executives and current administrators of major healthcare organizations • Offers degree and certi!cate programs in the fast-growing !eld of healthcare management Housed in UTHealth School of Public Health, the George McMillan Fleming Center for Healthcare Management provides rigorous training in healthcare management paired with a one-of-a-kind focus on population health. Learn more about our programs go.uth.edu/!emingcenter L E A R N F R O M L E A D E R S I N H E A LT H C A R E M A N A G E M E N T

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