Schiller AM, et al. - As early, accurate and reliable prediction of decompensation is necessary for the most efficient interventions and clinical outcomes in circulatory shock, researchers tested their hypothesis that the compensatory reserve (CRM) would better predict hemodynamic decompensation and provide greater specificity and sensitivity than metabolic measures. On healthy human subjects, they employed lower body negative pressure until symptoms of presyncope were evident. The ability of CRM, partial pressure of oxygen (pO₂), partial pressure of carbon dioxide (pCO₂), muscle oxygen saturation (SmO₂), lactate, end tidal CO₂ (EtCO₂), potential of hydrogen (pH), base excess and hematocrit (Hct) to predict hemodynamic decompensation was assessed by using receiver operating characteristic area under the curve (ROC AUC), sensitivity, and specificity. Findings revealed that superior detection of hemodynamic compensation was achieved with CRM vs commonly used clinical metabolic measures.