Austere environments Consortium for Enhanced Sepsis Outcomes

Austere environments Consortium for Enhanced Sepsis Outcomes

A Featured HJF Research Program

Austere environments Consortium for Enhanced Sepsis Outcomes

One of HJF’s newest supported programs is the Austere environments Consortium for Enhanced Sepsis Outcomes. Known by its acronym ACESO, HJF’s cooperative agreement with the Naval Medical Research Center-Frederick and the Naval Medical Logistics Command aims to improve survival for patients with sepsis in resource-limited settings through early recognition, diagnosis and evidence-based clinical management.

Sepsis is a systemic inflammatory syndrome that can occur in response to an infection. Some patients may progress to severe sepsis or septic shock, leading to life-threatening decreases in blood pressure and organ failure. Military personnel are at a particular risk of sepsis when deployed to austere regions with limited resources.

“We are trying to improve survival for patients with sepsis in settings where they don’t have access to the resources that you would find in a modern intensive care unit,” said Danielle Clark, Ph.D., ACESO deputy director and Southeast Asia regional director. “We have limited evidence on how to manage sepsis in those situations.”

As an epidemiologist with more than a decade dedicated to the international health arena, Clark understands the need for low-cost diagnostic and prognostic tests and evidence-based clinical management. Low-cost tests could guide decisions such as whether antibiotic treatment is necessary or whether an aggressive treatment regimen should be used.

The program aims to identify host-response-based markers that can predict whether a patient will have a severe clinical course or differentiate patients with a bacterial infection from patients with a viral infection. The program’s other focus is to inform and develop clinical management guidelines for treating patients with sepsis in austere settings.

The recommendations will be based on evidence derived from a clinical trial of patients with sepsis in Uganda. ACESO brings together a multidisciplinary team comprising Duke University, George Mason University, University of Washington, Naval Medical Research Units in Cambodia and Egypt, and Makerere University Walter Reed Project in Uganda. By using trained research staff, laboratory infrastructure and supply-chain logistics built by partners in Cambodia, Egypt and Uganda, the study can maximize the resources available for a comprehensive laboratory-testing panel and advanced analytic approach.

“We are looking to identify strategies and develop tools that will work in austere settings, which could include hospitals in developing countries or public health emergencies, such as a pandemic, in the U.S. or in other countries where facilities are overwhelmed and resources are limited,” Clark said.