SQUEEZE Trial: A Trial to Determine Whether Septic Shock Reversal is Quicker in Pediatric Patients Randomized to an Early Goal Directed Fluid Sparing Strategy vs. Usual Care

Inclusion Criteria: Inclusion Criteria for 1 and 3 must be answered YES to be eligible for study. * Age 29 days to less than 18 years of age * Patient has Persistent Signs of Shock including one or more of the following: * Vasoactive Medication Dependence * Hypotension (Systolic Blood Pressure and/or Mean Blood Pressure less than the 5th percentile for age) * Abnormal Perfusion (2 or more of: abnormal capillary refill, tachycardia, decreased level of consciousness, decreased urine output) * Suspected or Confirmed Septic Shock (Shock due to Suspected or Confirmed Infectious Cause) * Patient has received initial fluid resuscitation of: Minimum of 40 mL/kg of isotonic crystalloid (0.9% Normal Saline and/or Ringer's Lactate) and/or colloid (5% albumin) as fluid boluses within the previous 6 hours for patients weighing less than 50 kg, OR Minimum of 2 litres (2000 mL) of isotonic crystalloid (0.9% Normal Saline and/or Ringer's Lactate) and/or colloid (5% albumin) as fluid boluses within the previous 6 hours for patients weighing 50 kg or more. * Patient has Fluid Refractory Septic Shock as defined by the Presence of all of 2a, 2b, and 2c. Exclusion Criteria: * Patient admitted to the Neonatal Intensive Care Unit (NICU) * Patient requiring resuscitation in the Operating Room (OR) or Post-Anesthetic Care Unit (PACU) * Full active resuscitative treatment not within the goals of care * Shock Secondary to Cause other than Sepsis (i.e. obvious signs of cardiogenic shock, anap…