Assessing the response to vascular filling in shock is a challenge in emergency medicine.
The mitral annulus velocity measured by tissue Doppler (E') has recently been characterized as sensitive to the preload conditions of a patient.
The investigators hypothesize that the E' variation (∆E') before and after fluid filling allows us to assess the response to vascular filling. The investigators hypothesize that the ∆E' has a good diagnostic performance to establish whether a patient is responsive to fluid filling, defined by an area under the ROC curve greater than 0.75.
Patient has been informed of the study and does not refuse to participate.
Patient is at least ≥ 18 years of age.
The patient must be beneficiary of a health insurance plan.
Patient has shock with a mean blood pressure less than 65 mmHg (<)
The patient has already received 2 vascular fillings since the beginning of his management
The patient is in shock and has a contraindication to vascular filling : shock of a cardiogenic or obstructive nature
The patient has an intracranial pathology requiring maintain a MAP ≥ 80 mmHg
The patient is intubated or on Non-Invasive Ventilation before the vascular filling