Table 1.

Study population

Inclusion criteria: 1, 2, and 3 plus A, B, C, or D
1. New known or suspected infection (with a chance for source control if applicable)	A. Lactic acidosis and/or failure of lactic acid clearance
2. Multiorgan failure (≥ 2 organs failing)	B. Worsening acidosis despite adequate fluid resuscitation and/or dialysis
3. Two or more pressors, rapidly rising pressor needs, and/or inability to wean pressorsa	C. Mottling skin appearance despite appropriate resuscitation
	D. Acute drop in platelet count (± thrombocytopenia)
Exclusion criteria
Cardiogenic shock	Active metastatic malignancy
Hemorrhagic shock	Limitations to aggressive care
Ischemic colitis without surgery	Planned withdrawal of care
Cardiac arrest at presentation

^aHypotension must be due to sepsis