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Open Access 01-12-2014 | Conference Reports and Expert Panel

Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine

Authors: Maurizio Cecconi, Daniel De Backer, Massimo Antonelli, Richard Beale, Jan Bakker, Christoph Hofer, Roman Jaeschke, Alexandre Mebazaa, Michael R. Pinsky, Jean Louis Teboul, Jean Louis Vincent, Andrew Rhodes

Published in: Intensive Care Medicine | Issue 12/2014

Abstract

Objective

Circulatory shock is a life-threatening syndrome resulting in multiorgan failure and a high mortality rate. The aim of this consensus is to provide support to the bedside clinician regarding the diagnosis, management and monitoring of shock.

Methods

The European Society of Intensive Care Medicine invited 12 experts to form a Task Force to update a previous consensus (Antonelli et al.: Intensive Care Med 33:575–590, 2007). The same five questions addressed in the earlier consensus were used as the outline for the literature search and review, with the aim of the Task Force to produce statements based on the available literature and evidence. These questions were: (1) What are the epidemiologic and pathophysiologic features of shock in the intensive care unit? (2) Should we monitor preload and fluid responsiveness in shock? (3) How and when should we monitor stroke volume or cardiac output in shock? (4) What markers of the regional and microcirculation can be monitored, and how can cellular function be assessed in shock? (5) What is the evidence for using hemodynamic monitoring to direct therapy in shock? Four types of statements were used: definition, recommendation, best practice and statement of fact.

Results

Forty-four statements were made. The main new statements include: (1) statements on individualizing blood pressure targets; (2) statements on the assessment and prediction of fluid responsiveness; (3) statements on the use of echocardiography and hemodynamic monitoring.

Conclusions

This consensus provides 44 statements that can be used at the bedside to diagnose, treat and monitor patients with shock.

Refers also to the statements related to ‘general considerations’ and ‘plasma lactate, mixed venous oxygen saturation and central venous oxygen saturation and other perfusion markers’ discussed in the section "Diagnosis of shock")

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Title: Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine
Authors: Maurizio Cecconi
Daniel De Backer
Massimo Antonelli
Richard Beale
Jan Bakker
Christoph Hofer
Roman Jaeschke
Alexandre Mebazaa
Michael R. Pinsky
Jean Louis Teboul
Jean Louis Vincent
Andrew Rhodes
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 12/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-014-3525-z

At a glance: The STEP trials

Springer Medicine

Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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