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    Patent Pending

    Shock Index

    May be a more sensitive indicator of occult shock, especially in trauma or acute hemorrhage.
    When to Use
    Pearls/Pitfalls
    Why Use

    Consider in the following scenarios:

    • Patients presenting with hemorrhage and trauma, to identify patients at increased risk for transfusion.

    • Patients requiring endotracheal intubation, to help identify groups of patients at risk of post-intubation hypotension.

    • Patients with suspected sepsis (found to be as sensitive as the SIRS criteria to identify patients at risk for sepsis, Berger 2013); however, note that a large RCT showed that use of the Shock Index to guide fluid resuscitation in sepsis did not demonstrate a mortality improvement (ProCESS Investigators 2014).

    • There are currently no large scale prospective studies validating the use of the Shock Index to guide resuscitative intervention.

    • Shown to correlate with higher risk of mortality (likelihood ratio 5.67) and hospitalization (LR 6.64) at a cutoff of >1.3 (Al Jalbout 2019).

    • A pediatric age-adjusted Shock Index (SIPA) better differentiates severely injured children (up to 16 years of age) (Acker 2015).

    • Blood pressure and heart rate, when used individually, fail to accurately predict the severity of hypovolemia and shock in major trauma.

    • Massive transfusion of blood products can be associated with significant risk if initiated on the wrong patient. Identifying patients at risk for massive transfusion can be difficult, and objective measures like the Shock Index can help.

    • Shown to be more sensitive than the ABC Score for Massive Transfusion (Schroll 2018).
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    Creator Insights
    Dr. Manuel Mutschler

    About the Creator

    Manuel Mutschler, MD, is a practicing physician in the Department of Trauma and Orthopedic Surgery at the Cologne-Merheim Medical Center, affiliated with University of Witten/Herdecke. He is an active researcher with interests including hypovolaemic and hemorrhagic shock.

    To view Dr. Manuel Mutschler's publications, visit PubMed

    Are you Dr. Manuel Mutschler? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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