For the first Twitter Journal Club paper we have chosen Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock by Rivers et al (to access paper see http://bit.ly/jsxap2). This post aims to give some background to this paper and why so many on Twitter felt it was a good paper to start journal club with.
Sepsis is a medical emergency as any doctor who has been called to see a patient with suspected sepsis knows all too well. In my hospital every F1 starting their rotation is given a card asking in bold “Do you speak sepsis?” and giving details of the Sepsis Six – the six steps that you should be completing within the first hour of seeing such a patient. We are reminded over and over again that this is an emergency where time is of the essence. The OECD Report in 2001 (see http://ssc.sccm.org/background/worldsoldestkiller) found that severe severe sepsis accounts for as many deaths per year as lung, breast and colon cancer combined – a staggering figure.
Sepsis is caused by the body’s reaction to infection and is part of a continuum from a body wide inflammatory response to severe sepsis and septic shock (a terrifying thing for any doctor to manage). Time is of the absolute essence – these patients need treatment implementing within the first hour of them presenting (the sooner the better). Rivers et al published in 2001 examined the effects of early-goal directed therapy in patients with severe sepsis or septic shock before they were admitted to the intensive care unit. I won’t go into details on this paper – that is for tomorrow – but the impact of this paper can be clearly seen – it forms an important part of the Surviving Sepsis Campaign management guidelines. The website for this campaign is a fantastic resource and well worth a look http://www.survivingsepsis.org
Tomorrow (Sunday 5th June) at 8pm UK time (7pm GMT) we will be critiquing this paper in the first, of many I hope, Twitter Journal Club discussions. It would be fantastic to get as many people as possible involved in this discussion using the hashtag #twitjc.