CRI™ has a robust evidence base generated by clinicians and researchers from leading health systems
CRI trends with changes in intravascular volume relative to an individual patient’s response to hypovolemia, and should only be used by qualified medical providers as an adjunct to rather than as a replacement for traditional hemodynamic measures.
Changes in intravascular volume may occur from blood loss, dehydration or severe infections resulting in sepsis.
Hemorrhage
In the compensated shock stage, dangerous levels of blood and/or fluid loss go undetected by traditional vital signs2 Each minute of delay in administering blood increases mortality by 5% (among patients requiring massive transfusion)3
Key CRI findings for hemorrhage
CRI is a more sensitive indicator of blood loss than BP, Sp02, HR, base deficit, Hb/Hct, and shock index in trauma patients and controlled blood loss studies4-8 CRI is instantly and continuously available while lactate values are delayed by lab processing times (44 min), despite CRI and lactate having similar abilities to predict hemorrhage9
Dehydration
Lack of a rapid, noninvasive objective measure of dehydration contributes to unnecessary hospitalizations11 Late recognition of dehydration in the elderly, and under and overtreatment of children complicate patient care and are costly to the healthcare system11
Key CRI findings for dehydration
CRI reflects individual patient response to hypovolemia from hemorrhage, passive heat stress and exercise, trending to the point of decompensation2
Sepsis
Existing tools for screening and diagnosis of sepsis are often inaccurate12 Sepsis diagnosis after admission increases mortality rate 2x and hospital costs 3x (compared to early diagnosis)13
Key CRI findings for sepsis
CRI distinguished septic from non-septic patients with unparalleled sensitivity and specificity among a cohort of patients with surgical infection14
CRI is a proprietary technology with 13 families of patents in hemorrhage, dehydration, and sepsis
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1. Eastridge BJ, et al. Transfusion. 2019; 59:1423-1428. 2. Moulton SL, et al. J Trauma Acute Care Surg. 2017 Jul;83(1 Suppl 1):S104-S111. 3. Meyer DE, et al. J Trauma Acute Surg. 2017;83(1):19-24. 4. Nadler R, et al. Shock. 2014 Aug;42(2):93-8. 5. Stewart CL, et al. J Trauma Acute Care Surg. 2014 Dec;77(6):892-7; 897-8. 6. Convertino VA, et al. Shock. 2015 Aug;44 Suppl 1:27-32. 7. Stewart CL, et al. J Spec Oper Med. 2016 Spring;16(1):6-13. PMID: 27045488. 8. Johnson MC, et al. Shock. 2018 Mar;49(3):295-300. 9. Johnson MC, et al. J Trauma Acute Care Surg. 2017 Oct;83(4):603-608. 10. Mentes JC, et al. SAGE Open Nursing . 2019;5:1-8. 11. S. Kim. P Annals of Epidemiology. 2007;17(9):736. 12. Duncan, C.F., Youngstein, T., Kirrane, M.D. et al. Diagnostic Challenges in Sepsis. Curr Infect Dis Rep23,22 (2021). https://doi.org/10.1007/s11908-021-00765-y 13. Liang L (AHRQ), Moore B (IBM Watson Health), Soni A (AHRQ). National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2017. HCUP Statistical Brief #261. Month 2020. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb261-Most-Expensive-Hospital-Conditions-2017.pdf. 14. Benov A, et al. J Trauma Acute Care Surg. 2020 Aug;89(2S Suppl 2):S153-S160.