A new procedure under development by Simon Tilma Vistisen, assistant professor at the Research Centre for Emergency Medicine at Finland’s Aarhus University, could help doctors more accurately monitor the amount of fluid a sepsis patient receives.
“If this new monitoring method comes into use as early as in the emergency units, the doctors will be able to ensure that patients get the right amount of fluid from the very start,” says Vistisen. “Unlike today, when they have to rely on trial and error.”
The new method is based on the heart’s natural irregularities – instances where the heart beats an extra beat—which all people experience.
These premature contractions of the heart, known as extrasystoles, occur more often than every half hour in many patients.
“We all have these irregularities, when heart beats a tiny extra beat before it has completely filled with blood. The next heartbeat will then be delayed, which means the heart will then take in more blood than normally,” says Vistisen. “If you observe the heartbeat with an extra amount of blood, you get an image of how the heart will react to extra fluid.”
Over the next two years, Vistisen will be testing the new method, which can predict whether a patient needs more fluid or not, together with scientists from Aarhus University and Harvard University.
Typically a patient receives 10 liters of fluid during the first 24 hours after admission to the hospital with serious sepsis, commonly known as blood poisoning. The fluid ensures that the heart can maintain the patient’s blood pressure and pump enough blood to all the body’s tissue and organs. But right now there is no reliable way to tell if a patient has received too much or too little fluid.
This means that critically ill patients could get inadequate supplies of oxygen to their vital organs, while on the other hand, too much fluid could lead to it accumulating elsewhere in the body.