Hemodynamic phenotyping 4.0.

The concept of integrating hemodynamic variables to define specific profiles or phenotypes has been established for decades. Describing hemodynamic phenotypes plays a key role in educating healthcare professionals about cardiovascular physiology, enhancing the understanding of shock mechanisms, and informing treatment strategies. Recently, two notable innovations have emerged to support bedside identification of hemodynamic phenotypes: machine learning (ML) algorithms and visual decision support tools. When it comes to "small data," such as a limited set of hemodynamic variables, ML algorithms may not be essential for data integration or interpretation. In addition, the hemodynamic phenotypes identified by ML techniques often mirror traditional textbook profiles, though occasionally with inconsistencies that may impact patient safety. This raises valid questions about the need to integrate complex and proprietary ML algorithms for bedside hemodynamic assessment. By contrast, visual tools leverage clinicians' innate ability to process graphical information rapidly, improving the understanding of cardiovascular physiology and enabling recognition of hemodynamic profiles at a glance. As such, they may offer a practical, accessible, and cost-effective alternative to ML-based solutions. Future studies comparing the clinical impact of visual versus ML-driven phenotyping are now needed to guide further development and implementation.