Management of the circulation on ICU

The management of the circulation of the critically ill surgical patient is a major challenge and is becoming increasingly complex. Prompt recognition and treatment of acute circulatory failure, or shock, is crucial to improve the poor prognosis that most shock states carry. While critical care specialists may be involved in the later stages of the treatment process, the recognition, diagnosis and initial management of the shocked patient will often be the responsibility of the surgical team. This article aims to describe the different types of shock, the principles of diagnosis and basic and advanced haemodynamic monitoring, and finally it provides a basic strategy for the management of circulatory failure in the critically ill.