Haemodynamic monitoring and management of the hypotensive out-of-hospital cardiac arrest patient in the adult intensive care unit: a clinical consensus statement of the Association for Acute CardioVascular Care of the European Society of Cardiology (ESC)

Differentiating between hypotension with vs. without hypoperfusion is critical to avoid unnecessary interventions while ensuring adequate cerebral and myocardial perfusion.

Clinical assessment and repeated echocardiography should be routine in all patients.

Therapeutic targets should include evidence of preserved end-organ function, including urine output, and normal or decreasing lactate.

In selected cases, advanced haemodynamic monitoring with pulmonary artery catheters may be necessary to diagnose the shock-type and monitor treatment effects.

Causal treatment of the precipitating cause of hypotension is crucial as well as symptomatic treatment with fluids, vasopressors and inotropes if needed.

Mechanical circulatory support may be employed for refractory shock unresponsive to other treatment.