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https://www.readbyqxmd.com/read/28069417/standing-shock-index-an-alternative-to-orthostatic-vital-signs
#1
Michael D Witting
: Objective The lack of a sensitive, practical bedside test for hypovolemia has rekindled interest in the shock index (heart rate divided by systolic blood pressure). Here, we compare the effect of blood donation on standing shock index values with its effect on values for the supine shock index and orthostatic change in shock indicies (OCSI). METHODS: This is a re-analysis of data collected for an earlier report. Data were available from 292 adults below age 65 and 44 adults ages 65 and over, donating 450mL of blood...
December 23, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28063676/early-predictors-for-massive-transfusion-in-older-adult-severe-trauma-patients
#2
Takao Ohmori, Taisuke Kitamura, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, Ryu Tamura, Kentaro Muranishi, Toshiyuki Matsumoto, Takamitsu Tokioka
BACKGROUND: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/27997586/determination-of-normal-ranges-of-shock-index-and-other-haemodynamic-variables-in-the-immediate-postpartum-period-a-cohort-study
#3
Hannah L Nathan, Kate Cottam, Natasha L Hezelgrave, Paul T Seed, Annette Briley, Susan Bewley, Lucy C Chappell, Andrew H Shennan
OBJECTIVE: To determine the normal ranges of vital signs, including blood pressure (BP), mean arterial pressure (MAP), heart rate (HR) and shock index (SI) (HR/systolic BP), in the immediate postpartum period to inform the development of robust obstetric early warning scores. STUDY DESIGN: We conducted a secondary analysis of a prospective observational cohort study evaluating vital signs collected within one hour following delivery in women with estimated blood loss (EBL) <500ml (316 women) delivering at a UK tertiary centre over a one-year period...
2016: PloS One
https://www.readbyqxmd.com/read/27980279/shock-index-more-sensitive-than-cardiogenic-shock-in-st-elevation-myocardial-infarction-treated-by-primary-percutaneous-coronary-intervention
#4
Veemal V Hemradj, Jan Paul Ottervanger, Menko Jan de Boer, Harry Suryapranata
BACKGROUND: Cardiogenic shock (CS) is a strong predictor of mortality in patients with ST-elevation myocardial infarction (STEMI), but there is evidence that shock index (SI), taking into account both blood pressure and heart rate, is a more sensitive and powerful predictor. We investigated the independent impact of SI and CS on 30-day and 1-year mortality in patients with STEMI, treated by primary percutaneous coronary intervention (PCI).Methods and Results:In 7,412 consecutive patients with STEMI treated with primary PCI, the predictive value of either SI or CS on 1-year mortality was assessed...
December 16, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27955692/is-the-shock-index-based-classification-of-hypovolemic-shock-applicable-in-multiple-injured-patients-with-severe-traumatic-brain-injury-an-analysis-of-the-traumaregister-dgu-%C3%A2
#5
Matthias Fröhlich, Arne Driessen, Andreas Böhmer, Ulrike Nienaber, Alhadi Igressa, Christian Probst, Bertil Bouillon, Marc Maegele, Manuel Mutschler
BACKGROUND: A new classification of hypovolemic shock based on the shock index (SI) was proposed in 2013. This classification contains four classes of shock and shows good correlation with acidosis, blood product need and mortality. Since their applicability was questioned, the aim of this study was to verify the validity of the new classification in multiple injured patients with traumatic brain injury. METHODS: Between 2002 and 2013, data from 40 888 patients from the TraumaRegister DGU(®) were analysed...
December 12, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27916212/shock-index-as-a-predictor-of-myocardial-injury-in-st-segment-elevation-myocardial-infarction
#6
Jin Kyung Hwang, Woo Jin Jang, Young Bin Song, Joao A C Lima, Eliseo Guallar, Yeon Hyeon Choe, Soonuk Choi, Eun Kyoung Kim, Joo-Yong Hahn, Seung-Hyuk Choi, Sang-Chol Lee, Hyeon-Cheol Gwon
BACKGROUND: Little is known about the association between shock index and myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: We analyzed cardiac magnetic resonance imaging from 306 consecutive patients treated with primary PCI for STEMI. The patients were divided into the following 2 groups: initial shock index >0.7 (n = 88) and ≤0.7 (n = 218). Shock index was calculated as the ratio of heart rate to systolic blood pressure based on the first recorded vital signs upon arrival...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27893619/substituting-systolic-blood-pressure-with-shock-index-in-the-national-trauma-triage-protocol
#7
Ansab A Haider, Asad Azim, Peter Rhee, Narong Kulvatunyou, Kareem Ibraheem, Andrew Tang, Terence O'Keeffe, Hajira Iftikhar, Gary Vercruysse, Bellal Joseph
INTRODUCTION: The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance. METHODS: A 2-year (2011-2012) retrospective analysis of all trauma patients 18 years or older in the National Trauma Databank was performed...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27884923/clinical-metrics-in-emergency-medicine-the-shock-index-and-the-probability-of-hospital-admission-and-inpatient-mortality
#8
Kamna S Balhara, Yu-Hsiang Hsieh, Bachar Hamade, Ryan Circh, Gabor D Kelen, Jamil D Bayram
STUDY OBJECTIVES: The shock index (SI), defined as the ratio of HR to systolic BP, has been studied as an alternative prognostic tool to traditional vital signs in specific disease states and subgroups of patients. However, literature regarding its utility in the general ED population is lacking. Our main objective was to determine the probability of admission and inpatient mortality based on the first measured SI at initial presentation in the general adult ED population in our tertiary care centre...
November 24, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27879296/elevated-modified-shock-index-within-24-hours-of-icu-admission-is-an-early-indicator-of-mortality-in-the-critically-ill
#9
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Darrell R Schroeder, Timothy J Weister, Daniel A Diedrich
PURPOSE: To assess whether exposure to modified shock index (MSI) in the first 24 hours of intensive care unit (ICU) admission is associated with increased in-hospital mortality. METHODS: Adult critically ill patients were included in a case-control design with 1:2 matching. Cases (death) and controls (alive) were abstracted by a reviewer blinded to exposure status (MSI). Cases were matched to controls on 3 factors-age, end-stage renal disease, and ICU admission diagnosis...
November 21, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27857892/arterial-ammonia-levels-prognostic-marker-in-traumatic-hemorrhage
#10
Anurag Singla, Satinder Kaur, Navjot Kaur, C S Gill
BACKGROUND: In blunt trauma, extent of hemorrhage cannot be determined by physical examination, and vital signs may also not give clear picture in all the patients, especially young healthy ones. Hemorrhagic shock has been reported to increase blood ammonia levels. Arterial ammonia was analyzed in blunt trauma abdomen patients and correlated with shock index (SI). Its predictive value was determined for timely decision of intervention. MATERIALS AND METHODS: Hundred blunt trauma abdomen patients presented in the emergency ward of tertiary care hospital were included in the study...
October 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27851079/1443-modified-shock-index-as-a-predictor-of-icu-length-of-stay-sofa-score-and-mortality
#11
Namita Jayaprakash, Nathan Smischney, Rahul Kashyap, Jenkins Gregory, Ognjen Gajic
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850997/1361-prediction-of-myocardial-dysfunction-utilizing-modified-shock-index
#12
Namita Jayaprakash, Nathan Smischney, Rahul Kashyap, Jenkins Gregory, Ognjen Gajic
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850557/919-elevated-modified-shock-index-is-an-early-indicator-of-mortality-in-the-critically-ill
#13
Mohamed Seisa, Daniel Diedrich, Darrell Schroeder, Weister Timothy, Katherine Heise, Nathan Smischney
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849878/236-shock-index-as-a-marker-for-mortality-rates-in-those-admitted-to-the-micu-from-the-ed
#14
Nitasa Sahu
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27846895/development-and-validation-of-a-prehospital-prediction-model-for-acute-traumatic-coagulopathy
#15
Ithan D Peltan, Ali Rowhani-Rahbar, Lisa K Vande Vusse, Ellen Caldwell, Thomas D Rea, Ronald V Maier, Timothy R Watkins
BACKGROUND: Acute traumatic coagulopathy (ATC) is a syndrome of early, endogenous clotting dysfunction that afflicts up to 30% of severely injured patients, signaling an increased likelihood of all-cause and hemorrhage-associated mortality. To aid identification of patients within the likely therapeutic window for ATC and facilitate study of its mechanisms and targeted treatment, we developed and validated a prehospital ATC prediction model. METHODS: Construction of a parsimonious multivariable logistic regression model predicting ATC - defined as an admission international normalized ratio >1...
November 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27822945/validation-of-the-shock-index-modified-shock-index-and-age-shock-index-for-predicting-mortality-of-geriatric-trauma-patients-in-emergency-departments
#16
Soon Yong Kim, Ki Jeong Hong, Sang Do Shin, Young Sun Ro, Ki Ok Ahn, Yu Jin Kim, Eui Jung Lee
The shock index (SI), modified shock index (MSI), and age multiplied by SI (Age SI) are used to assess the severity and predict the mortality of trauma patients, but their validity for geriatric patients is controversial. The purpose of this investigation was to assess predictive value of the SI, MSI, and Age SI for geriatric trauma patients. We used the Emergency Department-based Injury In-depth Surveillance (EDIIS), which has data from 20 EDs across Korea. Patients older than 65 years who had traumatic injuries from January 2008 to December 2013 were enrolled...
December 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27820776/muscle-oxygenation-as-an-early-predictor-of-shock-severity-in-trauma-patients
#17
Lorilee S L Arakaki, Eileen M Bulger, Wayne A Ciesielski, David J Carlbom, Dana M Fisk, Kellie J Sheehan, Karin M Asplund, Kenneth A Schenkman
INTRODUCTION: We evaluated the potential utility of a new prototype noninvasive muscle oxygenation (MOx) measurement for the identification of shock severity in a population of patients admitted to the trauma resuscitation rooms of a Level I regional trauma center. The goal of this project was to correlate MOx with shock severity as defined by standard measures of shock: systolic blood pressure, heart rate, and lactate. METHODS: Optical spectra were collected from subjects by placement of a custom-designed optical probe over the first dorsal interosseous muscles on the back of the hand...
November 3, 2016: Shock
https://www.readbyqxmd.com/read/27814956/shock-index-pediatric-age-adjusted-sipa-is-more-accurate-than-age-adjusted-hypotension-for-trauma-team-activation
#18
Shannon N Acker, Brooke Bredbeck, David A Partrick, Ann M Kulungowski, Carlton C Barnett, Denis D Bensard
BACKGROUND: We demonstrated previously that shock index, pediatric age-adjusted identifies severely injured children accurately after blunt trauma. We hypothesized that an increased shock index, pediatric age-adjusted would identify more accurately injured children requiring the highest trauma team activation than age-adjusted hypotension. METHODS: We reviewed all children age 4-16 admitted after blunt trauma with an injury severity score ≥15 from January 2007-June 2013...
November 1, 2016: Surgery
https://www.readbyqxmd.com/read/27805998/big-children-or-little-adults-a-statewide-analysis-of-adolescent-isolated-severe-traumatic-brain-injury-outcomes-at-pediatric-versus-adult-trauma-centers
#19
Brian W Gross, Mathew M Edavettal, Alan D Cook, Cole D Rinehart, Caitlin A Lynch, Eric H Bradburn, Daniel Wu
BACKGROUND: The appropriate managing center for adolescent trauma patients is debated. We sought to determine whether outcome differences existed for adolescent severe traumatic brain injury (sTBI) patients treated at pediatric versus adult trauma centers. We hypothesized that no difference in mortality, functional status at discharge (FSD) or overall complication rate would be observed between center types. METHODS: All adolescent trauma patients (aged 15-17 years) presenting with isolated sTBI (head Abbreviated Injury Scale [AIS] score ≥3; all other AIS body region scores ≤2) to accredited level I-II trauma centers in Pennsylvania from 2003-2015 were extracted from the Pennsylvania Trauma Outcome Study database...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27800569/classification-of-high-risk-with-cardiac-troponin-and-shock-index-in-normotensive-patients-with-pulmonary-embolism
#20
Savas Ozsu, Muge Erbay, Zerrin Gürel Durmuş, Tevfik Ozlu
Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission...
October 31, 2016: Journal of Thrombosis and Thrombolysis
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