Published now in the Intensive Care Medicine Journal

The European Society of Intensive Care Medicine (ESICM) is pleased to announce the publication of its updated Guideline on Circulatory Shock and Haemodynamic Monitoring in Adult ICU Patients in the Intensive Care Medicine Journal.

This guideline provides updated, evidence-based recommendations on how to diagnose, monitor, and manage circulatory shock. Using PICO-framed clinical questions and graded evidence, the expert panel defined what to assess, when to intervene, and how to monitor patients in shock.

The panel issued 50 statements to help standardise assessment and support clinical decision-making. Key highlights include:

• The importance of serial tissue perfusion assessment
• Use of dynamic predictors of fluid responsiveness
• Targeted fluid administration rather than liberal approaches
• Arterial line and cardiac output/stroke volume monitoring in non-responders
• Echocardiography is the first-line tool to determine the type of shock

These recommendations aim to promote more precise, patient-centred management and improve outcomes for critically ill patients with circulatory shock.

Thanks to the efforts of the key opinion leaders and experts in shock management within ESICM.