Alirocumab in Patients with Sepsis

Inclusion Criteria: * Suspected or confirmed infection as evidenced by ordering of blood cultures and administration of at least one antimicrobial agent * Acute respiratory or cardiovascular organ dysfunction attributed to sepsis as evidenced by at least one of the following requirements: * Vasopressor Requirement - Continuous infusion of norepinephrine, epinephrine, vasopressin, dopamine, phenylephrine or other vasopressor agents at any dose for greater than 1 hour and required to maintain a mean arterial pressure ≥ 65 mm Hg despite intravenous crystalloid infusion of at least 1000cc * Respiratory Support Requirement - Acute hypoxemic respiratory failure defined as persistent hypoxemia requiring (1) intubation and mechanical ventilation, or (2) positive pressure ventilation via tight-fitting face mask or (3) high flow nasal cannula ≥ 45 liters per minute (LPM) flow and fraction of inspired oxygen (FiO2) ≥ 0.40 * Anticipated or confirmed intensive care unit (ICU) admission Exclusion Criteria: * Organ dysfunction present \> 24 hours at time randomization * Limitations of care (defined as refusal of cardiovascular and respiratory support described under inclusion criteria) including "do not intubate" (DNI) status * Development of sepsis while in the hospital ( i.e not present on admission to hospital) * Chronic hypoxemia requiring supplemental non-invasive oxygen or home mechanical ventilation * Chronic cardiovascular failure requiring home mechanical hemodynamic suppor…