In recent years considerable information has been gained with respect to both a better understanding of mechanisms in shock and in its management. Bacteremic shock continues to be a predominant problem in the hospital with 66% being of the gram-negative variety.1Although the Figure deals with surgical patients primarily, bacteremic shock is more prevalent and serious in medical patients (Table 1). The urinary tract is the most common source of bacteremia, but in recent years the lungs have become increasingly important (Table 1). The predominant cause of bacteremia isEscherichia coli; patients with bacteremia due to this microorganism have a low incidence of shock and the lowest mortality. Bacteremia fromPseudomonas aeruginosahas been rising in incidence and carries the gravest prognosis (Table 1). Twenty patients who had been under treatment elsewhere in the hospital were referred to the study unit with a clinical diagnosis of advanced or refractory