Diastolic shock index: Its importance and application in critically ill patients: A narrative review

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.