When is enough, enough? Physiological responses to fluid resuscitation in sub-Saharan African adults with sepsis

Sepsis affects 30 million people worldwide each year. In Malawi, more than 25% of adults with sepsis die despite antibiotic treatment. Without intensive care facilities, the main treatment is intravenous fluid, but it is not known when and how much should be given and giving too much or too little can both be harmful. Tailoring treatment to the individual is extremely difficult, and it is complicated by high rates of heart disease and HIV in the country, different infectious causes and limited healthcare resources.

I will examine how the heart, lungs and blood vessels of adults in sub-Saharan Africa are affected by sepsis using non-invasive techniques, including bedside ultrasound. I will see how this varies according to the cause of infection and delay in accessing healthcare. I will use this to produce mathematical models to predict outcomes such as death, kidney failure and waterlogged lungs. 

The models I create will identify beneficial treatment strategies, minimising the cost and risk of future clinical trials.