Forty-eight septic shock patients with positive blood cultures had conventional serial hemodynamic evaluations until recovery or death to identify early cardiovascular variables that predicted outcome. There were 19 (40%) survivors and 29 nonsurvivors. At the initial evaluation, both survivors and nonsurvivors demonstrated an elevated cardiac index (CI), low systemic vascular resistance index (SVRI), and normal stroke volume index. However, only an initial heart rate (HR) <106 beat/min significantly predicted survival. Twenty-four hours after the onset of shock, both an HR <95 beat/min and an SVRI > 1529 dyne ċ sec/cm5ċ m2predicted survival. Comparing the hemodynamic profiles from the initial to the 24 h time point, a decrease in HR > 18 beat/min or a decrease in CI > 0.5 L/min ċ m2predicted survival. Twenty-two deaths occurred in the first week of study, of which 18 (82%) were due primarily to low SVRI and four (18%) to low CI. Seven deaths occurred after 1 wk, all of which were due to multiple organ failure.