Blood pressure goals in the Intensive Care Unit (ICU) have been extensively studied using large datasets. Mean Arterial Pressure (MAP) has been historically used as a surrogate for end-organ perfusion. However recent studies have shown that hypoperfusion can precede hypotension and therefore perfusion pressure may be a more important target than mean arterial pressure, even more so in the critically ill patient population. In the cardiac ICU, blood pressure targets are tailored to the individual patient based on their cardiac pathophysiology and other comorbidities. Generally, the goal is to support end organ perfusion by maintaining the blood pressure within a certain range. However, this range can vary from patient to patient. Patients with different pathologies may require different thresholds of MAP/ perfusion pressure and hence there is a paradigm shift towards personalized therapy for critically ill patients and moving away from the one size fits all thought process. Historically, used serum markers such as lactate have also been replaced with newer and more specific markers of shock. Individualized targets demand the use of both invasive and noninvasive monitoring modalities and frequent titration of medications and/or mechanical circulatory support where necessary. This presentation aims to outline the risk factors and predictors of hypoperfusion and end organ failure in special patient populations and identifying individualized blood targets

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