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She has not taken part in the review or selection process of this article. AD: grants from the Australian National Health and Medical Research Council and Medical Research Future Fund paid to his Institution. MBS: MBS: Pfizer, AOP, Viatris, Biomerieux, Menarini. MSC: Edwards Lifesciences, Philips Healthcare, AOP, Laboratorie Agguetant, ESICM Chair Cardiodynamics section, ESICM Consensus on Shock and Haemodynamic Monitoring (co-chair), ESICM Consensus on Sepsis Induced Myocardial Dysfunction (co-chair). J.D.W. is supported by a Sr Clinical Research Grant from the Research Foundation Flanders (FWO, Ref. 1881020N) and consulted for Biomerieux, Menarini, MSD, Pfizer, Roche Diagnostics, ThermoFisher and Viatris (honoraria were paid to his institution). NH: Supported by a NHMRC Leadership Fellowship and Institutional Research Support from Baxter. MH is supported by a Tier 1 Canada Research Chair in Critical Illness Outcomes and the Recovery Continuum and receives funding support from the Canadian Institutes of Health. AKK: Medtronic, Edwards Lifesciences, Philips Research North America, Bayer Corporation, AOP, GE Healthcare, Innoviva Therapeutics, Viatris, SERB pharmaceuticals, Pharmazz Inc., Surviving Sepsis Campaign (Research Committee member), SCCM ESICM consensus definition of refractory septic shock (co-chair). Ongoing support Wake Forest CTSI: RAAS dysfunction in septic shock and NIH\/NHLBI R01HL177834-01: Dysfunctional Renin Angiotensin System in Septic Shock. FRM: Member of The SSC 2026 guidelines, speaker\u2019s fee from Baxter in 2025. AMD: Grants from Fischer Paykel and Terumo, and personal fees from Air Liquide, Terumo and Addmedica, all outside the submitted work. XM is a consultant for BD, Getinge and Pulsion Medical Systems. XM received honoraria for giving lectures from AOP health, Baxter healthcare, BD, Edwards Lifesciences, Getinge, Masimo and Philips healthcare. XM received an unrestricted research grant from Retia Medical, Masimo and Edwards Lifesciences. XM is an associate editor of Annals of Intensive Care, a member of the editorial board of Critical Care, and the editor-in-chief of Hemodynamics. SNM\u2014Member of the Surviving Sepsis Campaign (SSC) 2026 Guidelines Committee and SSC Research Committee. Member of the Asia Pacific Sepsis Alliance (APSA). OH: AOP Healthcare and Viatris. DDB: Edwards Lifesciences, AOP Pharma, Pharmaz, Viatris. BV: Supported by a NHMRC Leadership Fellowship and Institutional Research Support from Baxter. JD, GH, JL declare no potential conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}