Septic shock is associated with excessive sympathetic outflow, high plasma catecholamine levels, myocardial depression, vascular hyporeactivity, and autonomic dysfunction.1,2 Typically, patients have a low resistance, high-cardiac output circulation with tachycardia and arterial hypotension that may be poorly or even nonresponsive to exogenous catecholamine vasopressors. Although norepinephrine is the current recommended mainstay of treatment for sepsis-related hypotension,3 excessive adrenergic stress has multiple adverse effects including direct myocardial damage (eg, Takotsubo [stress] cardiomyopathy and tachyarrhythmias), insulin resistance, thrombogenicity, immunosuppression, and enhanced bacterial growth.4,5 High plasma catecholamine levels, the extent and duration of catecholamine therapy, and tachycardia are all independently associated with poor outcomes in critically ill patients.2,68  High sympathetic stress is also implicated in sepsis-induced myocardial depression.9