Midodrine in the Recovery Phase of Septic Shock

The investigators aim to investigate the use of midodrine in the recovery phase of septic
shock in a randomized control trial. The investigators hypothesize that midodrine use
initiated after stabilization or improving intravenous vasopressor requirement will lead to
decreased length of ICU stay and length of time that intravenous vasopressors are required.

The investigators plan to enroll and consent patients at the onset of septic shock. Once IV
vasopressor requirement is stabilized or decreasing, males and females will be randomized in
1:1 fashion to receive either standard clinical care or standard clinical care plus oral
midodrine. The investigators will analyze length of stay in the ICU, time on vasopressors,
time needing a central line, and hospital length of stay.

Inclusion Criteria:

- • Patients aged 18-99 years old

- Admitted to UVA medical ICU with diagnosis of septic shock.

Exclusion Criteria:

- Pregnant females, patients with childbearing potential will have urine pregnancy
testing after consent

- Patients < 18 years

- Prisoners

- Patients already taking midodrine

- Patients with cirrhosis and Child-Pugh Class C (Child-Pugh score > 9)_

- Patients with Increased intraocular pressure and glaucoma

- Patients with allergy to midodrine

- Non-English speaking patients

- Patients without enteral access

- Patients where the attending physician does not feel MAP goal of > 65 mmHg is
physiologically acceptable.