Related Experiment Video

Updated: Jan 16, 2026

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
08:45

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients

Published on: April 18, 2025

1.2K

Utility of Shock Index and Pediatric Age-Adjusted Shock Index in Predicting Severe Sepsis and Septic Shock

Raziye Merve Yaradilmiş1, Aytaç Göktuğ2, İlknur Bodur3

  • 1Department of Pediatric Emergency Care, Etlik City Hospital, Ankara.

Pediatric Emergency Care
|October 3, 2025
PubMed

Insights

The shock index (SI) and pediatric age-adjusted shock index (SIPA) aid in early sepsis recognition in children. Combining these with lactate or immature granulocytes (IG%) improves accuracy in pediatric emergency departments.

Area of Science:

  • Pediatric Emergency Medicine
  • Critical Care
  • Clinical Diagnostics

Background:

  • Early recognition of severe sepsis and septic shock in pediatric emergency departments (PEDs) is critical for effective treatment.
  • The shock index (SI) and pediatric age-adjusted shock index (SIPA) show promise for early risk stratification.
  • This study evaluated the predictive performance of SI, SIPA, and modified indices for severe outcomes.

Purpose of the Study:

  • To assess the predictive performance of SI, SIPA, and modified shock index variations in identifying severe sepsis and septic shock in pediatric patients.
  • To determine the utility of these noninvasive tools in the pediatric emergency department setting.

Main Methods:

  • A retrospective cohort study of 238 pediatric patients (1 month to 18 years) meeting systemic inflammatory response syndrome criteria.
  • Collected clinical data and vital signs, calculating SI, SIPA, and modified indices.
  • Recorded biomarkers including lactate and immature granulocyte percentage (IG%).

Main Results:

  • Severe sepsis or septic shock occurred in 20.6% of patients (49/238).
  • SI (≥1.81) demonstrated an AUC of 0.815 with 81.6% sensitivity and 67.7% specificity.
  • Age-specific SI cutoffs improved prediction, especially in younger children. Combining SI with IG% or lactate enhanced diagnostic accuracy.

Conclusions:

  • SI and SIPA are practical tools for early sepsis detection in children.
  • Age adjustment of SI enhances its accuracy.
  • Integration of SI with biomarkers like IG% and lactate can improve clinical decision-making in PEDs.
Abstract

Keywords:
pediatric age-adjusted shock indexsepsisseptic shocksevere sepsisshock index

More Related Videos

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock09:09

Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock

Published on: November 3, 2023

1.4K
Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research08:14

Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research

Published on: March 22, 2024

2.0K

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
255
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
254
Blood Pressure Imbalances and Circulatory Shock01:24

Blood Pressure Imbalances and Circulatory Shock

Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
1.6K
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
237
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
212