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These shock subgroups are generally considered homogeneous entities in research and clinical practice. This current definition fails to consider the complex pathophysiology of shock and the influence of patient heterogeneity. Recent translational evidence highlights previously under-appreciated heterogeneity regarding the underlying pathways with distinct host-response patterns in circulatory shock syndromes. This heterogeneity may confound the interpretation of trial results as a given treatment may preferentially impact distinct subgroups. Re-analyzing results of major \u2018neutral\u2019 treatment trials from the perspective of biological mechanisms (i.e., host-response signatures) may reveal treatment effects in subgroups of patients that share treatable traits (i.e., specific biological signatures that portend a predictable response to a given treatment). In this review, we discuss the emerging literature suggesting the existence of distinct biomarker-based host-response patterns of circulatory shock syndrome independent of etiology or hemodynamic profile. We further review responses to newly prescribed treatments in the intensive care unit\u00a0designed to personalize treatments\u00a0(biomarker-driven or endotype-driven patient selection in support of future clinical trials).<\/jats:p>","DOI":"10.1186\/s40635-023-00531-5","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T23:06:21Z","timestamp":1692313581000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Distinct host-response signatures in circulatory shock: a narrative review"],"prefix":"10.1186","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1489-4768","authenticated-orcid":false,"given":"Sabri","family":"Soussi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob C.","family":"Jentzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etienne","family":"Gayat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"P\u00f6ss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Schaubroeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filio","family":"Billia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick R.","family":"Lawler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"531_CR1","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1097\/CCM.0000000000004000","volume":"47","author":"CA Santacruz","year":"2019","unstructured":"Santacruz CA, Pereira AJ, Celis E, Vincent J-L (2019) Which multicenter randomized controlled trials in critical care medicine have shown reduced mortality? 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Dr. P.R.L. has received unrelated research funding from the Canadian Institutes of Health Research, the U.S. National Institutes of Health (National Heart, Lung, and Blood Institute), the Peter Munk Cardiac Centre, the LifeArc Foundation, the Thistledown Foundation, the Ted Rogers Centre for Heart Research, the Medicine by Design Fund, the University of Toronto, and the Government of Ontario. He also received unrelated consulting honoraria from Novartis, Corrona, and Brigham and Women\u2019s Hospital, as well as unrelated royalties from McGraw-Hill Publishing. Dr. A.M. has received speaker\u2019s honoraria from Abbott (Chicago, Illinois), Orion (Auckland, New Zealand), Roche (Basel, Switzerland), and Servier (Suresnes, France); and fees as a member of the advisory boards and\/or steering committees and\/or research grants from BMS (New York, New York), Adrenomed (Hennigsdorf, Germany), Neurotronik (Durham, North Carolina), Roche (Basel, Switzerland), Sanofi (Paris, France), Sphyngotec (Hennigsdorf, Germany), Novartis (Basel, Switzerland), Otsuka (Chiyoda City, Tokyo, Japan), Philips (Amsterdam, Netherlands) and 4TEEN4 (Hennigsdorf, Germany). Dr. J.P. receives institutional research funding from the German Cardiac Society, the German Heart Research Foundation and the Dr. Rolf M. Schwiete Foundation. Dr. FB receives unrelated research funding from the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada, the Peter Munk Cardiac Center, the Strauss Foundation, the Medicine by Design Fund. She has also received research funding from Abbott Laboratories.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"50"}}