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Brazilian Journal of Clinical Medicine and Review

Mini Review

Vol. 4 No. 1 (2026): January/December - 2026

Shock Index, FAST, and Hemostatic Resuscitation in Trauma-Induced Coagulopathy: Physiological Thresholds, Occult Shock, and Contemporary Decision-Making

DOI
https://doi.org/10.52600/2965-0968.bjcmr.2026.4.1.bjcmr55
Submitted
January 13, 2026
Published
2026-03-05

Abstract

Trauma-induced coagulopathy (TIC) is increasingly recognized as an early, endogenous, and pathophysiologically complex response to hemorrhagic shock, frequently preceding overt hypotension and clinical deterioration. Despite substantial advances in trauma systems, the timely identification of patients who will require massive transfusion remains a major determinant of survival. The Shock Index (SI), defined as the ratio of heart rate to systolic blood pressure, has emerged as a practical and physiologically grounded marker capable of identifying occult hypoperfusion during the compensated phase of shock. This perspective provides an in-depth discussion of SI thresholds, integration with bedside imaging, contemporary hemostatic resuscitation strategies, and the evolving role of machine learning–based decision support. Particular emphasis is placed on real-world clinical implementation across heterogeneous healthcare systems, including low-resource environments.

 

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