To investigate the benefit of using the AFM and Eadyn-guided fluid and vasopressor therapy in septic shock resuscitation for mechanically ventilated patients compared with the standard of care. The investigators hypothesize that using the AFM and Eadyn-guided fluid/vasopressor titration in septic shock patients who underwent mechanical ventilation might reduce the time to shock reversal.
All Thai consecutive patients older than 18 years with a diagnosis of sepsis or septic shock in medical ICU, defined by clinically suspected or confirmed infection and MAP <65 mmHg according to the criteria of the Surviving Sepsis Campaign 2021(11)with onset of shock in less than 24 hours.
Already receiving or planning for mechanical ventilation
Already receiving or planning for arterial catheter placement for invasive arterial pressure monitoring
All patients will receive an echocardiogram with a cut point of LVEF > 30% to be included in the study
Active, immediate, life-threatening cardiac arrhythmia, defined as ventricular tachycardia and ventricular fibrillation
Acute cerebral vascular event, including both acute ischemic stroke or intracranial hemorrhage
Acute coronary syndrome
cardiogenic shock, acute heart failure