Inclusion Criteria:  Patients ≥ 18 years old Diagnosis Septic Shock from the definition of SEPSIS III in intensive care unit at Siriraj hospital and Hat-Yai hospital Receive fluid resuscitation at least 30 ml/kg and/or Vasopressor until mean arterial pressure ≥ 65 mmHg Persistence lactate >2mmol/L at 6th hour after resuscitation Urine output < 0.5 ml/kg at 6th hour after resuscitation Left ventricular ejection fraction (LVEF) < 40 %  Exclusion Criteria:  Chronic kidney disease stage 5 and denied renal replacement therapy Life-threatening tachyarrhythmia before enrolled e.g. Ventricular tachycardia, Ventricular fibrillation Patient sign do-not-resuscitation and terminally ill