Does the patient present with any of the following:
High illness severity and low cardiac output present as evidenced by:
- Low blood pressure despite vasoactive agents, elevated filling pressures
- Elevated lactate (> 4 mmol/L)
- Low mixed venous saturation (< 50%)
- End organ dysfunction:
- Renal (low urine output)
- Liver (transaminitis, hypoglycemia, coagulopathy)
- CNS (depressed mental state)