Hemodynamic Resuscitation Guided by Non-Invasive Mean Systemic Filling Pressure to Prevent Acute Kidney Injury in Septic Shock

Inclusion Criteria: * Adult patients (Age 18 years or older) admitted to the Intensive Care Unit. * Primary diagnosis of Septic Shock defined according to the Third International Consensus Definitions for Sepsis (Sepsis-3): Sepsis with persisting hypotension requiring vasopressors to maintain MAP 65 mmHg or greater and having a serum lactate level greater than 2 mmol/L despite adequate volume resuscitation. * Patients must be mechanically ventilated and sedated to ensure baseline hemodynamic stability. * Presence of an invasive arterial catheter and a central venous catheter. Exclusion Criteria: * Known pre-existing chronic kidney disease (CKD Stage 4 or 5) or patients on chronic renal replacement therapy. * Contraindications to arm cuff inflation, including upper limb trauma, -lymphedema, arteriovenous fistula, or peripheral vascular disease. * Severe valvular heart disease, specifically severe tricuspid regurgitation, which invalidates CVP interpretation. * Intra-abdominal hypertension (Intra-abdominal pressure greater than 15 mmHg) which mechanically alters venous return independent of blood volume. * Moribund patients with a predicted mortality within 24 hours.