The Sepsis Spectrum

Sepsis doesn’t just overwhelm the body, it can turn the lungs into ground zero for multi-organ dysfunction. In this episode, host Nicole Kupchik sits down with Dr. Julie Bastarache to explore how sepsis triggers Acute Respiratory Distress Syndrome (ARDS) in a significant portion of critically ill patients. Dr. Bastarache explains why sepsis-induced ARDS isn’t a single entity but a spectrum of clinical, physiologic and biologic responses, each requiring its own approach. From the fundamentals of mechanical ventilation and why low tidal volume remains lifesaving, to the emerging, and surprising protective effects of GLP-1 receptor agonists, Dr. Bastarache’s reverse translational science bridges bedside observations back into the lab, to uncover new pathways and potential therapies. Plus, mental health counselor Kristan Seaford, shares her Sepsis Survival story of how pushing through the holiday season while caring for children sick with strep and the flu, led her to overlooking her own symptoms until she was fighting for her life.

Featured Guests:

Julie Bastarache, MD (@JulesBass6), is a physician scientist who specialized clinically in pulmonary and critical care medicine. She cares for patients in the intensive care unit who have a variety of life-threatening problems including pneumonia, sepsis (a severe infection that causes organs to shut down), respiratory failure, and shock. Despite advances in ICU care, many patients admitted to the ICU die and those that survive often have permanent problems like kidney failure, trouble thinking, weakness, and low oxygen levels. 

Key Takeaways:

Sepsis damages the lungs in 30-40% of patients making ARDS one of the most visible and deadly expressions of systemic inflammation.

ARDS is not a single disease, it's driven by a cascade of mechanisms ranging from mechanical, physiologic and biologic failure all at once.

High-flow nasal cannula is a powerful bridge therapy. It supports oxygenation and may prevent intubation, especially useful in COVID-19 related ARDS.

The best ventilator mode is the one clinicians understand well. Simplicity and mastery often outperform switching to complex modes, especially considering low tidal volume ventilation has been proven as a mortality-reducing ventilation strategy.

GLP-1 receptor agonists show promise in protecting organs during sepsis. Patients on these medications appear less likely to develop sepsis or organ injury, mouse models confirm improved survival

The future of sepsis and ARDS lies in precision medicine, moving away from broad labels towards targeted categories that enable more effective and individualized treatments.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit Sepsis.org

Produced by: Human Content and Sepsis Alliance

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. 

Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

Acute kidney injury (AKI) is far more dangerous and complex than previously understood. In this episode, host Nicole Kupchik sits down with Dr. Gonzalo Matzumura to break down what really happens inside the kidneys during sepsis. From disrupted renal perfusion, tubular cell injury, and overwhelming inflammation, clinicians and, more importantly, patients, face high stakes when it comes to treating sepsis-related AKI. Dr. Matzumura sheds light on why prevention, recognition, and calling in the nephrologist earlier can mean the difference between lifelong disease, kidney replacement therapy, and full recovery. We’re also joined by Josh and Chelsea Woodward who share their powerful sepsis survival story, recounting how just a few red spots on Josh’s skin quickly spiraled into a medical crisis, underscoring just how quickly AKI and sepsis can escalate and why awareness is essential.

Featured Guests:

Gonzalo Matzumura Umemoto, MD,(@GMatzumura) is an Assistant Professor of Medicine in the Division of Nephrology at Washington University School of Medicine. He serves as the Director of Acute Dialysis Services at Barnes-Jewish Hospital.

Key Takeaways:

Nearly 45-70% of acute kidney injuries in the ICU are linked to sepsis, making early recognition critical for improving survival.

Kidney-toxic medications used during sepsis treatment (vancomycin, gentamicin, amphotericin, vasopressors) can worsen AKI, requiring careful dosing and monitoring.

Creatinine levels lag 24-48 hours, meaning kidney injury is often detected too late; clinicians need better biomarkers and early monitoring.

Fluid resuscitation requires balance. Overload can precipitate the need for kidney replacement therapy, especially in oliguric patients.

Sepsis-related AKI is multifactorial, involving inflammation, immune activation, microcirculatory dysfunction, and in some cases, mitochondrial injury.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit Sepsis.org

Produced by: Human Content and Sepsis Alliance

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. 

Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

Host Nicole Kupchik is joined by Dr. Kaveh Hoda to unpack one of the most overlooked drivers of sepsis: the gut. Often called “the motor of MODS,” the GI tract can push the body toward recovery, or accelerate systemic collapse. In this episode, Dr. Hoda explains the importance of microbiome diversity, the breakdown of gut barriers leading to leaks and inflammation, and how critical illness disrupts the small intestine. More importantly, he shares what clinicians can do to support GI function at the bedside, from early nutrition strategies and listening to bowel sounds, to C.diff management. Plus, Sepsis Survivor Hailey Bain shares her story of septic shock, which was triggered by a ruptured appendix and originally mistaken for gynecologic pain. Her experience highlights how sepsis can escalate if early warning signs are missed.

Featured Guests:

Kaveh Hoda, MD, Gastroenterologist, Hepatologist and Host of The House of Pod

Twitter @thehouseofpod

BlueSky @KavehMD

Key Takeaways:

The gut is a central driver, not a bystander in sepsis. The GI tract can ignite systemic inflammation, worsen organ failure, and shape overall prognosis.

Critical illness rapidly destroys microbiome diversity. Within days in the ICU patients lose microbial variety, a major blow to immunity, mucosal integrity, and gut resilience.

Even good bacteria can become harmful. Under stress and illness, bacteria that were once benign can act more virulent and contribute to sepsis progression.

Antibiotics, proton pump inhibitors, and ICU stress can compound damage. While necessary interventions, they also accelerate microbiome disruption, making the gut even more vulnerable

Clostridioides difficile, formerly known as clostridium difficile (C.diff) thrives when the microbiome collapses, however fecal microbiota transplant (FMT) has been changing the game. The transplant remains one of the most effective modern treatments for recurrent C.diff in critically ill patients.

Sepsis survivors can struggle with long-term gut and nutrition problems. Muscle wasting, anorexia, IBS, malnutrition and increased infection risk require holistic post-ICU care and high protein nutrition.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit Sepsis.org

Produced by: Human Content and Sepsis Alliance

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. 

Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

In this episode, Nicole Kupchik sits down with Dr. Craig Jenne to unravel how the liver’s immune response shifts during sepsis. Together, they explore how an organ known for detoxifying and defending the body can actually fuel inflammation and injury. From leukocyte traps to immune misfires, we’re looking at the cellular chaos behind sepsis and what it takes to restore balance. A fascinating deep-dive for clinicians, researchers, and anyone curious about the unseen complexity of critical illness.

Featured Guests:

Dr. Jenne (@JenneLab) is a Professor within the Department of Microbiology, Immunology and Infectious Diseases, the Department of Critical Care Medicine at the University of Calgary and holds an adjunct appointment within the Faculty of Veterinary Medicine. Dr. Jenne is the Jessie Boden Lloyd Professor in Immunology Research and is the Deputy Director of the Snyder Institute for Chronic Disease. 

Key Takeaways:

Understand how the liver acts as both a frontline defender and a potential amplifier of damage during sepsis, particularly when immune cells shift from protection to overreaction.

Explore the role of the liver’s microvasculature and immune cells, like Kupffer cells and neutrophils, in modulating inflammation and capturing pathogens, and how these processes can spiral into collateral damage.

Learn why “leukocyte traps” (NETs) might be protective at first, but dangerous later, contributing to tissue damage, clotting, and worsening sepsis outcomes.

Gain insight into why timing matters in liver-driven immune response, and how early interventions might reduce secondary injury and help prevent long-term organ dysfunction.

See how this research might inform new therapies, including those that protect organ function without suppressing the immune system too early.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit Sepsis.org

Produced by: Human Content and Sepsis Alliance

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. 

Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

What if the key to controlling inflammation, and even saving lives from sepsis, lies not in the bloodstream, but in the brain? In this episode, Nicole Kupchik talks with Dr. Kevin J. Tracey, President and CEO of the Feinstein Institutes for Medical Research at Northwell Health, whose groundbreaking work in neuroimmunology and bioelectronic medicine is redefining how we understand the vagus nerve and how it communicates with the immune system to regulate inflammation. From surprising results of sheep studies to the promise of vagus nerve stimulation devices, Dr. Tracey explains how rethinking the body’s electrical signs could transform sepsis care, redefine inflammation, and reveal new frontiers in treatment. We also hear from Kimberly Emanuel, a sepsis survivor who endured the breakdown of her body systems before her remarkable recovery. 

Featured Guests:

Kevin J. Tracey, MD. (X: KevinJTraceyMD) is President & CEO of the Feinstein Institutes for Medical Research and also serves as a Professor of Neurosurgery and Molecular Medicine at the School of Medicine at Hofstra/Northwell. Dr. Tracey’s focus is on neuro-immunology and bioelectronic medicine, having researched the neural circuits that regulate immune responses and currently integrating his findings into novel therapies for inflammation. Learn more about his work with neural circuits and the vagus nerve with his new book The Great Nerve. LinkedIN: Kevin J. Tracey, MD.

Key Takeaways:

Inflammation is not just a symptom of sepsis, it’s a process controlled by neural circuits that can be studied and potentially modulated. 

Using devices to stimulate the vagus nerve has shown remarkable results in reducing inflammation in conditions like rheumatoid arthritis and may hold promise for sepsis treatment.

Redefining sepsis through a neuroimmunology lens may help identify patients at risk earlier and personalize treatment based on neural-immune activity. 

Damage to the vagus nerve, as seen in severe COVID-related sepsis, can worsen inflammation and impair recovery. 

Understanding “sickness behavior” (lethargy, confusion, brain fog) as a neural-immune response could change how clinicians recognize and manage sepsis-related encephalopathy. 

The next era of sepsis care may rely as much on neuroscience as on antibiotics, shifting focus from killing microbes to restoring immune balance.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit Sepsis.org

Produced by: Human Content and Sepsis Alliance

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. 

Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

When sepsis strikes, the damage doesn’t always end with the infection. Nicole Kupchik is joined by Dr. Mitchell Elkind from the American Heart Association to explore how inflammation during sepsis can overwhelm the cardiovascular system, causing arrhythmias, heart failure, and even stroke. From acute AFib to long-term heart damage and the hidden role of cytokines, we dig into the silent injuries that outlast recovery. Plus, we hear a powerful firsthand story from sepsis survivor Mary Millard, whose cardiac journey illustrates the complex chain reaction that infection can trigger.

Featured Guests:

Mitchell Elkind, MD, MS, FAHA (X: AHAScience), is the American Heart Association’s Chief Clinical Science Officer and serves as the senior staff science leader for all Association initiatives related to stroke, brain health, and new integrated efforts including cardio-renal-metabolic health. 

Key Takeaways:

A startling percentage of sepsis patients experience heart complications, including those with no cardiac history

Sepsis survivors may carry hidden cardiovascular risks for months, or even years, after discharge.

Inflammation and clotting are deeply intertwined, and both can leave permanent marks on the heart and brain.

Sepsis may someday be recognized as a formal cardiovascular risk factor, just like diabetes or hypertension.

Research into statins, GLP-1s, and anti-inflammatory treatments is opening new doors for post-sepsis care.

—

Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit Sepsis.org

Produced by: Human Content and Sepsis Alliance

Sepsis is a life-threatening emergency that happens when your body’s response to an infection damages vital organs and, often, causes death. In other words, it’s your body’s overactive and toxic response to an infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis can lead to severe sepsis and septic shock. 

Sepsis Alliance is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

Season 2 is just around the corner for The Sepsis Spectrum! In this special bonus episode, Nicole Kupchik reflects on what we learned last season, how cancer can’t keep her away, and what’s next for the pod. Joining Nicole is Grady Health System Critical Care Clinical Nurse Specialist, Barbara McLean. Together, they have an honest, open conversation about sepsis, survivorship, and Season 2 which is all about sepsis and Multi Organ Dysfunction Syndrome (MODS).

Plus, we’re calling for YOUR stories! Share real world cases and lived experiences with MODS to be featured in season two. To submit, visit: www.human-content.com/sepsis
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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit EndSuperbugs.org

Produced by: Human Content and Sepsis Alliance

What you don’t track, you can’t fix, and too often, we’re not even looking. Nicole is joined by sepsis survivors Dr. Hilary Spangler and Jackie Duda, along with pediatric ICU nurse-scientist Dr. Mallory Perry-Eaddy, for a raw conversation about what happens after survival. From missed red flags in special populations to long-term trauma and broken feedback loops, this episode is a wake-up call for teams ready to see the full picture of sepsis care.

Featured Guests:

Hillary Spangler, MD (@http://linkedin.com/in/hillary-spangler): Internal medicine physician and health systems innovator focused on hospital quality, sepsis diagnostics, and patient-centered care.

Mallory Perry-Eaddy, PhD, RN, CCRN (@ https://www.linkedin.com/in/mallory-perry/): Critical care nurse scientist and sepsis researcher studying ICU survivorship, racial disparities, and long-term recovery.

Jackie Duda, Sepsis Survivor and Advocate (@jackiesjourney4): Sepsis survivor and advocate raising awareness of post-sepsis challenges and the vital role of caregiver voices in healthcare transformation.

Key Takeaways:

Understand why patients living with chronic disease (such as pediatrics, older adults, and the immunocompromised) need tailored approaches for infection prevention, AMR, and sepsis care.

Recognize age- and population-specific pathogens—and why empiric antibiotic decisions carry different risks for different groups.

Learn how antimicrobial stewardship can help protect vulnerable patients long-term by preserving their microbiome and slowing resistance.

Explore how vaccination and proactive prevention strategies can play a frontline role in managing AMR and sepsis—especially in high-risk groups.

Dive into the lasting impacts of AMR and sepsis in specialty populations and how those outcomes shape clinical decisions, recovery, and future risk.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit EndSuperbugs.org

Produced by: Human Content and Sepsis Alliance

When crisis hits every layer of care, how do you keep patients feeling human? Nicole is joined by Dr. Mark Mikkelsen and sepsis survivor Katy Grainger for a raw and powerful conversation for a raw and powerful conversation on how sepsis survival is only the beginning of a long and often difficult journey. This episode takes a closer look at the physical, mental, and emotional challenges that many sepsis survivors face after leaving the hospital—struggles that can persist for months or even years. They'll examine current discharge and follow-up practices and envision a more connected, survivor-centered model of post-sepsis care; one that recognizes how AMR and readmission can complicate recovery, and how personalized recovery planning can make all the difference.

Featured Guests:

Mark Mikkelsen, MD, MSCE (@MarkMikkelsenMD): Pulmonary and critical care physician leading national work on sepsis definitions, data science, and care improvement strategies.

Katy Grainger, Sepsis Survivor and Advocate (@Katysepsisamputee): Sepsis survivor and double amputee advocating for prevention, public awareness, and equitable care.

Key Takeaways:

Take a closer look at the physical, mental, and emotional hurdles sepsis survivors often face after hospital discharge.

Understand how antimicrobial resistance can complicate recovery, especially for patients with long-term infections or limited access to follow-up care.

Examine whether today’s discharge and follow-up practices are meeting the long-term needs of survivors or leaving them behind.

Explore what a more connected post-sepsis care model could look like with better communication, structured check-ins, and survivor-centered planning.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit EndSuperbugs.org

Produced by: Human Content and Sepsis Alliance

Sometimes what we call prevention is really just harm repackaged. Nicole, Dr. Hudson Garrett, and Armando Nahum dig into the paradoxes of infection control, where well-meaning efforts can produce unseen consequences. They explore the culture of blame, AMR and sepsis awareness pitfalls, and the need to refocus on patient experience. A provocative discussion for infection preventionists and frontline clinicians and leaders alike.

Featured Guests:

Hudson Garrett, PhD, MSN, MPH, FNP-BC, IP-BC, CPPS, AS-BC, VA-BC, NCEE, FACDONA, DICO-C, CFER, FAAPM (https://www.linkedin.com/in/drhudsongarrett/)Infection prevention expert and healthcare epidemiologist focused on policy, implementation science, and safety culture.

Website | X | Facebook

Armando Nahum (https://www.linkedin.com/in/armandonahum/): National patient advocate and health equity leader who transformed personal tragedy into systemic change in hospital-acquired infection prevention, becoming the Co-Founder and President of the Safe Care Campaign https://www.safecarecampaign.org/

Key Takeaways:

Understand how system failures in infection prevention and QI contribute to missed HAIs and hospital-onset sepsis.

Identify safety blind spots like delayed recognition, antibiotic overuse, and communication breakdowns and why they persist.

Explore how antimicrobial stewardship protects not just populations, but individual patients at their most vulnerable.

Learn why real sepsis prevention takes more than protocols; it takes visibility, accountability, and leadership.

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Get in Touch: [email protected]

Or Visit Us At: SepsisPodcast.org

Connect with Nicole on Socials: @nicolekupchik

Connect with Sepsis Alliance on Socials: @sepsisalliance

To Learn More About Sepsis, Visit EndSuperbugs.org

Produced by: Human Content and Sepsis Alliance