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LEARNING
IN D.C |
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“The real knowledge is to know the extent of one’s ignorance.”
Confucius.
That people with severe blood infection stands more chances for
survival was one of the best news at the annual conference on
Critical Care Medicine held two weeks ago, in Washington, DC, the
nation capital.
Ten years ago, people admitted to an intensive care unit with blood
infection, in a state of shock (collapse of the circulation), would
die in a proportion of 8 out of 10. Today, this rate is decreased to
3 or 4, out of 10. This has been a major stride for physicians,
intensivists who care for these very sick patients.
This evolution did not occur over night. It has been the fruit of
oft-frustrating research, but also of a better application of
knowledge and techniques already available to caregivers.
The innovation in this area seems to relate, among others, to the
strict control of the blood sugar level, even in the non-diabetic
person. Studies have demonstrated that if the blood sugar remains
within normal limits (70-110), the patient with blood infection, even
if he is not diabetic, is more likely do better. The question now is
whether these patients should be placed automatically on insulin
coverage.
Finally, a breakthrough. For too many years, the medical community
has been trying to find a substance capable of interfering with the
cascade of chemical reactions occurring in sepsis (loosely defined as
severe blood infection). The failing score has been high.
Now, for the first time in history, a medication seems to work. It
has been authorized on the open market. Its name is XGris, the
commercial name for dotrecogin alpha.
Still, research reveals that only one patient out of sixteen will
benefit from XGris. Low? Of course, but at least, we have
broken
with nothingness.
At the end of the rough learning week (14 grueling daily hours of
conferencing), I was to acknowledge, once again, that: “All I know is
that I know nothing.” (Aristotle)
(OdlerRobert Jeanlouie, Wednesday, April 24, 2002)
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