Key result
Diastolic shock index >3 predicts mortality and shock progression, identifying patients needing early vasopressors.
Why the study?
The clinical utility and evidence-based data of the diastolic shock index in various critically ill conditions remain to be comprehensively determined.
Does the diastolic shock index help predict clinical outcomes and guide therapy in critically ill patients?
Does the diastolic shock index help predict clinical outcomes and guide therapy in critically ill patients?
The diastolic shock index is a useful prognostic tool in critically ill patients, including those with myocardial infarction, to predict mortality and guide early vasopressor use.
May support DSI-guided norepinephrine initiation in shock; leaves open prospective randomized validation.
A recently developed method to measure vasodilatation is the diastolic shock index (DSI), which can be calculated by dividing heart rate by diastolic blood pressure. The DSI plays a significant role in many medical conditions. The focus of this review is to determine the evidence-based data of diastolic shock index in various conditions. Current trials recommend adding norepinephrine when diastolic arterial pressure is below 40 mmHg or diastolic shock index is more than 3. Besides, recent trials have studied the diastolic shock index in myocardial infarction, the peri-intubation period, the intraoperative period, and emergency department triage. Higher diastolic shock index value at presentation of severe cases of sepsis could identify patients who might benefit from early vasopressors and predict the progression of septic shock in emergency department triage. Moreover, it could help as a tool to identify a higher risk of death in myocardial infarction and peri-intubation period hypotension. However, the cut-off points for the diastolic shock index vary across different conditions.
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Owattanapanich et al. (2025) conducted a review in Critically ill patients. Diastolic shock index was evaluated. A diastolic shock index >3 identifies critically ill patients who may benefit from early vasopressors and predicts higher risk of death or shock progression.
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