A 45-year-old male patient with severe sepsis is showing signs of decreased perfusion despite adequate fluid resuscitation. Which of the following vasopressors is the best initial choice to improve the patient's blood pressure and perfusion?
Dopamine
Epinephrine
Phenylephrine
Norepinephrine
Norepinephrine is considered the first-line vasopressor for patients with septic shock who remain hypotensive despite adequate fluid resuscitation. It has potent alpha-adrenergic effects, leading to vasoconstriction and increased systemic vascular resistance, which help to improve blood pressure and perfusion. Epinephrine and dopamine can be considered in specific circumstances or as additional agents, but norepinephrine is preferred due to its more favorable balance of efficacy and side effects. Phenylephrine is typically a second-line option in patients with certain contraindications to norepinephrine.
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