Inclusion Criteria:  Age ≥ 18  The presence of acute circulatory insufficiency defined by the following pragmatic criteria:  Prior administration of at least 1000 mL of crystalloid or colloid solute during a volemic expansion in the previous 12 hours Norepinephrine administration/lactate ≥ 1.5 mmol/L  Exclusion Criteria:  No strict exclusion criterion only if the refusal of the patient.