Abstract
Introduction This observational study explores the Peripheral Perfusion Index (PPI) as a predictor of hypotension and mortality in sepsis. By correlating PPI with clinical outcomes, it assesses its potential for early diagnosis and goal-directed therapy, aiming to improve sepsis management beyond traditional blood pressure-based methods for better patient outcomes. Objectives To evaluate the role of the PPI in the early diagnosis and targeted treatment of septic shock, providing insights for improving clinical management and early intervention. Material and method This prospective study conducted at a tertiary medical centre, a medical college in Bihar, compares septic shock outcomes between Group 1 (the PPI group), with septic shock diagnosed with PPI <1.4; treatment guided by PPI >2, and Group 2 (the control group), diagnosed by traditional shock criteria (systolic blood pressure <90 mmHg or >40 mmHg drop from baseline) with standard bundle treatment. Result PPI-guided therapy significantly improved hemodynamic stabilization, reduced hypotension (28% vs. 50%), decreased mortality (12.5% vs. 31.3%), and shortened ICU stays (5 ± 2 vs. 8 ± 3 days) compared to traditional shock criteria. PPI demonstrated strong predictive value for hypotension (area under the receiver operating characteristic curve (AUROC) 0.86) and mortality (AUROC 0.89), supporting its clinical utility in sepsis. Conclusion This study confirms PPI's reliability in septic shock management, advocating a shift from mean arterial pressure (MAP)-focused to PPI-guided therapy for better outcomes.