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[Odler]

?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)