A critically ill patient with septic shock remains hypotensive despite 30 mL/kg crystalloid administration. Which vasopressor is the first-line agent of choice?
Answer and explanation
Correct answer: B. Norepinephrine infusion
Answer: Norepinephrine infusion.
Why not the others: Epinephrine is a second-line agent added when arterial pressure remains inadequate; Dopamine increases tachyarrhythmias and excess mortality compared with norepinephrine; Phenylephrine produces pure alpha-1 vasoconstriction without inotropic support, compromising cardiac index.
Why not the others: Epinephrine is a second-line agent added when arterial pressure remains inadequate; Dopamine increases tachyarrhythmias and excess mortality compared with norepinephrine; Phenylephrine produces pure alpha-1 vasoconstriction without inotropic support, compromising cardiac index.
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