Figure. 2 Clinical course of this case until 24 h (A) and until 12 days (B). (A) The patient showed severe hypotension and hyperlactatemia on arrival. Despite the infusion of catecholamines and arginine vasopressin (AVP), the pulse contour cardiac index remained low. The intra-aortic balloon pumping (IABP) was introduced 7 h after admission. After IABP introduction, the mean arterial pressure increased and the lactate levels decreased. Dobutamine and noradrenaline were titrated at 24 h after admission. (B) Continuous renal replacement therapy (CRRT) and mechanical ventilation were introduced on day 1. After IABP introduction, catecholamines and AVP were titrated and discontinued by day 5. The urine volume increased from day 5 and CRRT was discontinued on day 7. Mechanical ventilation was discontinued on day 11. AVP – arginine vasopressin; CRRT – continuous renal replacement therapy; DOB – dobutamine; IABP – intra-aortic balloon pumping; Lac – lactate; MAP – mean arterial pressure; NAD – noradrenaline; PCCI – pulse contour cardiac index.