1
|
Diaztagle Fernández JJ, Castañeda-González JP, Trujillo Zambrano JI, Duarte Martínez FE, Saavedra Ortiz MÁ. Assessment of the shock index in septic shock: A systematic review. Med Intensiva 2024:S2173-5727(24)00194-2. [PMID: 39054217 DOI: 10.1016/j.medine.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 06/19/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To identify published research on the Shock Index (SI) in patients with septic shock or severe sepsis and to describe its main findings and conclusions. DESIGN Systematic review of the literature following the recommendations of the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). SETTINGS The following databases were consulted: Pubmed, Embase, Library Cochrane and Lilacs. PATIENTS Patients older than 14 years with septic shock. Pregnant women and population with COVID-19 were excluded. INTERVENTIONS Studies reporting measurement of the shock index or its modified variants. MAIN VARIABLES OF INTEREST Absolute frequencies and relative frequencies were assessed with measures of central tendency and dispersion. Effect estimators (OR, RR and HR) were extracted according to the context of each study. RESULTS Seventeen articles were included, of which 11 investigated the SI as a predictor of mortality. Seven of them found significant differences in the SI when comparing survivors to non-survivors and observed a relationship between the SI evolution and clinical outcomes. Additional research evidenced a relation between the Modified Shock Index and myocardial depression, as well as mortality. Furthermore, they identified a relationship between the Diastolic Shock Index, the dose of administered dobutamine, and mortality. CONCLUSIONS The results suggest that both the SI and its modified versions, particularly in serial assessments, can be considered for evaluating patient prognosis. The SI can also aid in determining fluid management for patients.
Collapse
Affiliation(s)
- Juan José Diaztagle Fernández
- Servicio de Medicina Interna, Fundación Universitaria de Ciencias de la Salud - FUCS, Hospital de San José de Bogotá. Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Juan Pablo Castañeda-González
- Semillero de Investigación en Medicina Interna, Fundación Universitaria de Ciencias de la Salud - FUCS, Bogotá, Colombia
| | | | | | | |
Collapse
|
3
|
Haemodynamic coherence in perioperative setting. Best Pract Res Clin Anaesthesiol 2016; 30:445-452. [PMID: 27931648 DOI: 10.1016/j.bpa.2016.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 10/21/2016] [Accepted: 10/27/2016] [Indexed: 11/23/2022]
Abstract
Over the last decade, there has been an increased interest in the use of goal-directed therapy (GDT) in patients undergoing high-risk surgery, and various haemodynamic monitoring tools have been developed to guide perioperative care. Both the complexity of the patient and surgical procedure need to be considered when deciding whether GDT will be beneficial. Ensuring optimum tissue perfusion is paramount in the perioperative period and relies on the coherence between both macrovascular and microvascular circulations. Although global haemodynamic parameters may be optimised with the use of GDT, microvascular impairment can still persist. This review will provide an overview of both haemodynamic optimisation and microvascular assessment in the perioperative period.
Collapse
|
4
|
Ochagavía A, Baigorri F, Mesquida J, Ayuela JM, Ferrándiz A, García X, Monge MI, Mateu L, Sabatier C, Clau-Terré F, Vicho R, Zapata L, Maynar J, Gil A. [Hemodynamic monitoring in the critically patient. Recomendations of the Cardiological Intensive Care and CPR Working Group of the Spanish Society of Intensive Care and Coronary Units]. Med Intensiva 2013; 38:154-69. [PMID: 24296336 DOI: 10.1016/j.medin.2013.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 10/20/2013] [Indexed: 12/14/2022]
Abstract
Hemodynamic monitoring offers valuable information on cardiovascular performance in the critically ill, and has become a fundamental tool in the diagnostic approach and in the therapy guidance of those patients presenting with tissue hypoperfusion. From introduction of the pulmonary artery catheter to the latest less invasive technologies, hemodynamic monitoring has been surrounded by many questions regarding its usefulness and its ultimate impact on patient prognosis. The Cardiological Intensive Care and CPR Working Group (GTCIC-RCP) of the Spanish Society of Intensive Care and Coronary Units (SEMICYUC) has recently impulsed the development of an updating series in hemodynamic monitoring. Now, a final series of recommendations are presented in order to analyze essential issues in hemodynamics, with the purpose of becoming a useful tool for residents and critical care practitioners involved in the daily management of critically ill patients.
Collapse
Affiliation(s)
- A Ochagavía
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
| | - F Baigorri
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - J Mesquida
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - J M Ayuela
- Servicio de Medicina Intensiva, Hospital de Burgos, Burgos, España
| | - A Ferrándiz
- Servicio de Medicina Intensiva, Hospital Universitario General de Castellón, Castellón, España
| | - X García
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - M I Monge
- Servicio de Cuidados Críticos y Urgencias, Hospital del SAS Jerez, Jerez de la Frontera, Cádiz, España
| | - L Mateu
- Servicio de Medicina Intensiva, Hospital Universitario General de Castellón, Castellón, España
| | - C Sabatier
- Servicio de Medicina Intensiva, Hospital de Sabadell, CIBER Enfermedades Respiratorias, Corporació, Sanitària Parc Taulí, Institut Universitari Parc Tauli, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - F Clau-Terré
- Institut Reçerca, Hospital de Vall d'Hebron y Consorci Sanitàri Terrasa, Barcelona, España
| | - R Vicho
- Servicio de Medicina Intensiva, Clínica USP-Palmaplanas, Palma de Mallorca, España
| | - L Zapata
- Servicio de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Maynar
- Servicio de Medicina Intensiva, Hospital Universitario Araba, Vitoria, Álava, España
| | - A Gil
- Servicio de Cuidados Críticos y Urgencias, Hospital del SAS Jerez, Jerez de la Frontera, Cádiz, España
| |
Collapse
|