The current standard approach to manage circulatory insufficiency is inappropriately simple and clear: respond to low blood pressure to achieve higher values. However, the evidence for this is limited affecting all steps within the process: assessment, decision making, therapeutic options, and treatment effects. We have to overcome the ‘one size fits all’ approach and respect the dynamic physiologic transition from fetal to neonatal life in the context of complex underlying conditions. Caregivers need to individualize their approaches to individual circumstances. This paper will review various clinical scenarios, including managing transitional low blood pressure, to circulatory impairment involving different pathologies such as hypoxia-ischemia and sepsis. We will highlight the current evidence and set potential goals for future development in these areas. We hope to encourage caregivers to question the current standards and to support urgently needed research in this overlooked but crucial field of neonatal intensive care.

当前管理循环功能不全的标准方法过于简单明了：应对低血压以达到更高的值。但是，这方面的证据有限，无法影响该过程的所有步骤：评估，决策，治疗选择和治疗效果。我们必须克服“千篇一律”的方法，并在复杂的基础条件下尊重从胎儿生命到新生儿生命的动态生理转变。护理人员需要针对具体情况进行个性化处理。本文将回顾各种临床情况，包括管理过渡性低血压，涉及不同病理学（例如缺氧缺血和败血症）的循环系统损害。我们将重点介绍当前证据，并为这些领域的未来发展设定潜在目标。我们希望鼓励护理人员质疑当前的标准，并支持这一被忽视但至关重要的新生儿重症监护领域中急需的研究。