Fig. 1.

The course of serum lactate (orange dashed line, left y-axis) and noradrenalin dose (red solid line, right y-axis). The green arrow (arrow 1) indicates the initiation of continuous hemodialysis. The black arrow (arrow 2) indicated the addition of vasopressin and hydrocortisone to noradrenalin. The blue arrows (arrows 3 and 4) indicate a bolus of methylene blue 2 mg/kg intravenously. As noradrenalin levels could be rapidly decreased after the first methylene blue injection, the first blue arrow therefore also indicates the start of shock reversal.