Keywords
diastolic
shock
index
sepsis
septic shock
vasopressor
Introduction
DSI is a recently established track and trigger tool utilised in predicting vasodilatory shock, hence identifying patients at increased risk for requiring vasopressor, escalation of vasopressor dose and poor outcomes as increased morbidity & mortality. It gives the ratio of heart rate to diastolic blood pressure as a function of vascular tone.
Objectives
1. to describe relationship between DSI and sepsis & septic shock outcomes
2. to describe DSI values associated with vasopressor requirement
3. outline other prognostic markers associated with vasopressor requirement
Methods
article and journal reviews of descriptive observational studies
Results
elevated DSI was associated with progressive worsening of vasoplegia with subsequent elevated Vasopressor requirement. some reports showed relationship between elevated DSI and raised lactate levels being associated with poor outcome in patients with sespsis
Discussion
Descriptive and stratification methods utilised for quantile analyses of various categories of DSI values and adverse outcomes validated using multivariable logistic regression models
DSI ranges > 2.0 mostly associated with adverse outcomes, with score >2.5 being associated with mortality as an outcome
Conclusion
DSI is a useful tool easily available at the bedside, and can be used to predict patients at different risks . score >2.0 recommended to start vasporessors early. African and regional studies required. RCT also necessary
References
Ospina-Tascón, et al. “Using the diastolic shock index to determine when to promptly administer vasopressors in patients with septic shock
