Known by it’s acronym, ACESO, the Austere environments Consortium for Enhanced Sepsis Outcomes 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,” explains Danielle Clark, Ph.D., ACESO deputy director and Southeast Asia regional director. “We have limited evidence on how to manage sepsis in those situations.”
ACESO focuses on a variety of needs for battling sepsis in austere environments, in particular the need for low-cost diagnostic and prognostic tests and evidenced-based clinical management. Low-cost diagnostic and prognostic tests could guide decisions such as whether antibiotic treatment is necessary, or whether to use an aggressive treatment regimen. ACESO 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 multi-disciplinary team comprised of researchers from The Henry Jackson Foundation for the Advancement of Military Medicine, Inc., Duke University, George Mason University, Makerere University Walter Reed Project (Uganda), Komfo Anoke Teaching Hospital (Ghana) and US military research organizations. To accomplish the work, the study leverages existing capabilities in Uganda, Cambodia, and Ghana, and will expand soon to Liberia. By using trained research staff, laboratory infrastructure and supply-chain logistics built by established partners, the study can maximize the resources available for a comprehensive laboratory testing panel and advanced analytic approach.
ACESO's mission is well articulated by Clark who explains, “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 US or in other countries where facilities are overwhelmed and resources are limited. By learning more about sepsis, we can better serve our military members, US citizens, and populations around the globe."