Inclusion Criteria:  Septic shock patients, according to The Third International Consensus Definitions for Sepsis and Septic Shock and Is receiving intravenous norepinephrine 0.2 mcg/kg/min or more, or equivalent dose of other vasoactive agents  Exclusion Criteria:  One who has  acute coronary syndrome life-threatening arrhythmias acute ischemic stroke life-threatening, uncontrolled bleeding underlying conditions judged to have with limited life expectancy (less than 6 months) by primary physicians  One who is  judged by treating physicians as in moribund state and expected not to survive to 24 hours regardless of treatment given known to be pregnant at enrollment not in the competent state to give informed consent and not having relatives to do so not willing to pursue intensive medical therapy considered standard of care for patients with septic shock