3. Administration (after intravascular volume resuscitation) of nitroglycerin, reverses microcirculatory shutdown and shunting in septic shock patients. In severe heart failure and cardiogenic shock, microcirculatory alterations are also frequently encountered and vasodilation may reverse this condition. Although the components of this treatment protocol are not innovative (and will also be available in the standard therapy group), guiding of this treatment by serial measurements of blood lactate levels is.