• Jean-Louis Vincent, Diego Orbegozo Cortés, and Angela Acheampong.
• Erasme University Hospital, université libre de Bruxelles, Department of Intensive Care, route de Lennik 808, 1070 Brussels, Belgium. Electronic address: jlvincen@ulb.ac.be.
• Presse Med. 2016 Apr 1; 45 (4 Pt 2): e99-e103.

AbstractEarly and adequate resuscitation of patients with acute circulatory failure is important to restore the balance between oxygen needs and delivery. Haemodynamic management can globally be separated into three categories according to the VIP mnemonic - Ventilate, Infuse, Pump - which should be considered simultaneously in the patient with shock. Sufficient oxygen should be given early, and endotracheal intubation and mechanical ventilation performed without hesitation if there is any indication that oxygenation is inadequate. Fluids should be administered using the SOSD mnemonic - Salvage, Optimization, Stabilization, De-escalation. After initial liberal administration, ongoing requirements should be guided by repeated fluid challenges using a combination of balanced crystalloid solutions and colloid. Noradrenaline is the vasopressor of choice and should be started early. Dobutamine may be needed to improve myocardial contractility and cardiac output. Haemodynamic support should be personalized according to individual patient characteristics and global and regional parameters of haemodynamic and oxygenation status. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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