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The Bank of Sepsis of Vall d'Hebron, one of the three in the world, already has more than a thousand patient samples



Thanks to this bank, there are already two major projects underway: one to develop a device for rapid diagnosis of sepsis and another to stratify patients.

The Bank of Sepsis of the Vall d'Hebron University Hospital already holds more than a thousand samples of patients. This is one of only three banks of sepsis that exist around the world and is the only one of these characteristics that exists in the country. Sepsis is a complex disease, induced by an infection, which causes changes in the function of the main vital organs and, where more than 20% of the cases, can cause death. In the country, 17,000 people die every year from this pathology. The other two sepsis banks are at the Mayo Clinic in Rochester, Minnesota, USA, and the University of Jena, Germany. When the Sepsis Code is activated in the hospital (when it detects that a patient has this condition), blood is drawn from the patient to analyse the function of his or her vital organs and to identify the microorganism responsible for the infection. A part of that blood is stored in tubes that are kept in the Bank of Sepsis, frozen at 80 éC below zero. Subsequently, those responsible for the Bank of Sepsis contact the patients or their families to request their consent to donate their samples for research purposes. The Bank consists of various collections. A collection of samples from patients with sepsis, including serum, plasma and whole blood from more than 1,000 donors who have been diagnosed and treated at our hospital, a collection of samples obtained from these patients 24-48 hours before they developed sepsis, and a collection of follow-up samples collected 24 hours, 72 hours and one week after the onset of the disease. In addition, the Bank of Sepsis has a collection of samples from people without sepsis that serves as a control, which is made up of samples from healthy volunteers and patients who have presented a systemic inflammatory response syndrome of non-infectious origin.As explained by Dr. Juan Carlos Ruiz, co-director of the Bank and member of the Intensive Medicine Service of the Vall d'Hebron Hospital, "apart from the samples that make up the different collections mentioned above, clinical information related to sepsis of each patient who has suffered from the disease and has donated his or her blood samples is also recorded. This information is stored in secure and properly anonymized databases. In this way, studies can be performed while preserving the anonymity of the patients." The Bank of Sepsis is integrated in the Biobank of the Vall d'Hebron University Hospital, directed by Dr. Isabel Novoa. As Dr. Ruiz, who is also researcher of the Shock, Organic Dysfunction and Resuscitation Group of the Vall d'Hebron Research Institute (VHIR) explains, "the function of this Bank of Sepsis is to serve as a basis for scientific studies to improve the diagnosis and treatment of this pathology. It is a very useful tool, since we have multiple correctly preserved samples, clinical information and the consent of the Clinical Research Ethics Committee, which greatly facilitates research on such a complex and serious pathology." Two studies underway thanks to the Bank of SepsisVall d'Hebron is participating in the RAIS project, a European initiative financed by the European Commission, which aims to develop a rapid diagnosis system for sepsis. "Currently, the microbiological diagnosis of sepsis, which includes the identification of the microorganism and the study of its antibiotic sensitivity, can take up to 24-72 hours. While this information is not available, the patient is given antibiotic treatment empirically. Until we have the precise diagnosis we cannot properly adjust the therapy," adds Dr. Juan José González, co-director of the bank and member of the Microbiology Service of Vall d'Hebron. The aim of the RAIS project, which is coordinated by the ICFO-Photonic Sciences Institute, is to develop "a system that allows diagnosis in 30 minutes because the delay in adequate treatment is associated with an increase in morbidity and mortality," says this expert. Vall d'Hebron leads one of the lines of this project, which has to do with the search for microRNAs that can be used as very early biomarkers of the disease. "These molecules have been little explored in the field of sepsis due to their complexity. But, thanks to the collection of samples that patients with sepsis have donated, to the fact that they are stored in a standardized way in the Bank and to the latest generation technology used by our research group, we can now study them," says Dr. González, who is also a researcher at the VHIR Microbiology Group. The second of the studies being carried out is a project, coordinated by Eurecat (Technological Centre of Catalonia), "to stratify patients with sepsis according to their proteomic and metabolomic profile, i.e., the study of proteins and metabolites in patients with sepsis, using powerful Big Data analysis tools," explains Dr. Ruiz. It is therefore a question of "knowing as much as possible the characteristics of the microorganisms that trigger sepsis as well as the processes that occur in the patient. All this is essential to develop strategies allowing to diagnose, prevent and treat the disease properly," adds Dr. González. Sepsis Code in Vall d'HebronWhen a patient admitted or treated at the Vall d'Hebron University Hospital is diagnosed with sepsis, the Sepsis Code is activated. This is a circuit focused on treating this pathology in a comprehensive, multidisciplinary manner, as early as possible and with maximum excellence. The different professionals involved follow a pre-set protocol which aims to try to reduce the mortality of these patients as well as the development of complications that may lead to serious sequelae. This code involves a large number of professionals from different areas of the hospital such as the ICU, Emergency, Traumatology, Paediatrics, Microbiology, Biochemistry, Immunology, etc.

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