Taming The SRU
Taming The SRU - By Josh Ferreri - March 30, 2023
Ref: Ospina-Tascón GA, Teboul J-L, Hernandez G, et al. Diastolic shock index and clinical outcomes in patients with septic shock. Ann Intensive Care 2020;10(1):41. 10.1186/s13613-020-00658-8
TAKEAWAY
Further research on this topic should be considered in order to offer truly practice-changing evidence. However, the question asked by the researchers is one that has the potential to have a major clinical impact. The diastolic shock index is something that can be calculated less than 30 seconds after the patient enters the resuscitation bay. As such, it does not rely on various laboratory values in order to create a clinically beneficial prediction tool. If one’s index of suspicion is high enough for septic shock, and the patient has an elevated DSI, it may cause the provider to pause for a moment and consider aggressive resuscitation and possibly early vasopressor use. However, as was mentioned above, this study merely suggests a correlation between elevated DSI values and mortality, but it does not provide a practical cut off that can be universally applied to patients presenting with septic shock. This study should prompt the reader to think critically about the clinical and physiologic plausibility of the DSI and its utility in sepsis management. However, further research must be done to validate its clinical use.