Shock index

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The shock index (SI) is the heart rate (HR) divided by systolic blood pressure (SBP) .

The pretransport shock index can predict the need for resuscitation in the hospital[1].

Other variations are[2]:

  • Shock index (SI) is the heart rate / systolic blood pressure (SBP). The normal range is 0.5–0.7
  • Modified Shock Index (MSI) is the heart rate / mean arterial pressure (MAP)
  • Age Shock Index (age SI) is SI * age.

Of these three measures, for GI bleeding, Age SI may better prognosticate[2].

In the ProCESS randomized controlled trial, titrating to a shock index of < 0.8 after mini-boluses of fluids, had similar mortality to other methods of monitoring fluids[3].

Additional studies have been done[4].

References

  1. St John AE, McCoy AM, Moyes AG, Guyette FX, Bulger EM, Sayre MR (2018). "Prehospital Lactate Predicts Need for Resuscitative Care in Non-hypotensive Trauma Patients". West J Emerg Med. 19 (2): 224–231. doi:10.5811/westjem.2017.10.34674. PMC 5851492. PMID 29560047.
  2. 2.0 2.1 Kocaoğlu S, Çetinkaya HB (2021). "Use of age shock index in determining severity of illness in patients presenting to the emergency department with gastrointestinal bleeding". Am J Emerg Med. 47: 274–278. doi:10.1016/j.ajem.2021.05.008. PMID 33993044 Check |pmid= value (help).
  3. ProCESS Investigators. Yealy DM, Kellum JA, Huang DT, Barnato AE, Weissfeld LA; et al. (2014). "A randomized trial of protocol-based care for early septic shock". N Engl J Med. 370 (18): 1683–93. doi:10.1056/NEJMoa1401602. PMC 4101700. PMID 24635773. Review in: Ann Intern Med. 2014 Jun 17;160(12):JC9
  4. van Bergen KMG, van Kooten L, Eurlings CGMJ, Foudraine NA, Lameijer H, Meeder JG; et al. (2022). "Prognostic value of the shock index and modified shock index in survivors of out-of-hospital cardiac arrest: A retrospective cohort study". Am J Emerg Med. 58: 175–185. doi:10.1016/j.ajem.2022.05.039. PMID 35696802 Check |pmid= value (help).

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