Presented by Mr Gareth Richards, Department of Oncology and Metabolism

Septic shock (also known as blood poisoning) is a complication of infection which leads to dangerously low blood pressure. Worldwide incidence is 20 million cases p.a. (150,000 in UK), with mortality up to 50%. The condition is a major cause of deaths in intensive care, affecting patients of all ages but has additional effects on the elderly and their recovery and ability to lead independent lives post recovery. 

Septic shock arises from primary infections of urinary or respiratory tracts, infected catheters in hospital patients, after childbirth (particularly in less well-developed countries), or unknown origins, often after surgery. The common feature is that bacteria circulate in the blood and trigger a Systemic Inflammatory Response Syndrome (SIRS) in vessels. 

This leads to several life-threatening events, but the most acute is catastrophically low blood pressure, causing impaired supply to organs which begin to fail. Without treatment, death follows. While treatment of underlying infection is a major goal in SIRS, immediate maintenance of life requires elevation of blood pressure. Intravenous fluids have limited effect in SIRS, because the cause of low blood pressure is increased vascular permeability and widespread peripheral vasodilation both linked to high circulating levels of the hormone adrenomedullin. We are aiming to develop novel drugs which the actions of adrenomedullin to maintain critical blood pressure long enough so anti-bacterial therapy can work and increase survival and decrease recovery times.