ESICM Shock 2025 — ESICM guidelines on circulatory shock and hemodynamic monitoring 2025
European Society of Intensive Care Medicine, 2025
Use serial multimodal perfusion assessment, dynamic tests rather than static preload markers to predict fluid responsiveness, cardiac-output/stroke-volume monitoring when shock persists, and echocardiography as first-line imaging to define shock phenotype.
Clinical Context & Relevant Topics (5)
Disease ReferenceCellular dysoxia, DO2/VO2 physiology, the 4 shock phenotypes, dynamic fluid responsiveness (PLR/PPV) vs fluid tolerance (VExUS), and vasoactive pharmacology.
The subset of sepsis with profound circulatory and cellular/metabolic abnormality — clinically identified by a vasopressor requirement to maintain MAP ≥ 65 mmHg plus lactate > 2 mmol/L despite adequate fluid resuscitation.
Primary pump failure, SCAI staging (A–E), PAC hemodynamics (CPO, PAPi), inotrope selection, emergent revascularization, and mechanical circulatory support.
Extracardiac mechanical barriers to filling or ejection: Massive PE, Cardiac Tamponade, Tension Pneumothorax, and Auto-PEEP.
From arterial and venous waveforms to PA catheterization, echo, fluid responsiveness, pressure-volume loops, and integrated shock phenotyping.