A Trial of Adjunctive Fludrocortisone (50mcg, 100mcg or Placebo) in Critically Ill Patients With Septic Shock Receiving Hydrocortisone, Evaluating Survival and Functional Recovery and the Influence of Transcriptomic Response
2. Treatment with vasopressors to maintain a Systolic Blood Pressure (SBP) \>90mmHg or Mean Arterial Pressure (MAP) \> 65mmHg, after having received adequate fluid resuscitation (in the opinion of the treating clinician)
3. Plasma lactate concentration \>2mmol/L
4. Being treated with hydrocortisone 200mg/day as adjunctive treatment for septic shock
5. Being treated with one of the following:
1. Invasive Mechanical Ventilation OR
2. Non-invasive ventilation (CPAP or BiPAP) OR
3. Oxygen supplementation with an oxygen flow of \>10L/min independent of delivery system and an FiO2 of 0.5 or above., OR
4. Use of Veno-venous ECMO
2. Death is deemed imminent or inevitable by treating ICU specialist
3. Patients with documented systemic fungal infection at the time of randomisation
4. Patients with documented allergy to fludrocortisone
5. Patients unable to receive enteral medications
6. An underlying disease process with a life expectancy of less than 28 days
7. Pregnancy (confirmed or suspected)
8. Receiving hydrocortisone (HC) or fludrocortisone (FC) for conditions other than septic shock
9. Prior enrolment in this trial
10. Known or documented objections to research participation
