Does the patient present high illness severity and low cardiac output as evidenced by:

Imminent risk of cardiac arrest
Refractory respiratory failure
End organ dysfunction:
- Renal (low urine output)
- Liver (transaminitis, hypoglycaemia, coagulopathy)
- CNS (depressed mental state)
Elevated lactate and rapid rise, metabolic acidosis, wide AV-O2 difference (>30%)
Low blood pressure despite vasoactive agents, tachycardia, elevated filling pressures