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A 75- year old male presents to your ED, with SOB, fever, purulent sputum and a history of recurrent pneumonia. His BP is 70/30, HR is 130, SpO2 90% and RR 30. You suspect he is in septic shock and start fluid resuscitation with crystalloid and broad-spectrum antibiotics. He receives 2L of Ringer’s lactate but his MAP is still < 60. What is your next step?