Which statement best describes the first-line vasopressor therapy for septic shock?

• A. Increases systemic vascular resistance and MAP
• B. Increases heart rate
• C. Decreases afterload
• D. Increases diuresis

Answer: (C)

In septic shock, the immediate goal is to reverse the dangerous vasodilation and restore perfusion by raising the pressure in the arteries. The first-line vasopressor does this mainly by constricting blood vessels, which increases systemic vascular resistance and mean arterial pressure. This helps ensure organs receive enough blood flow to function and prevents further organ injury.

Norepinephrine, the typical first-line agent, achieves this through alpha-adrenergic vasoconstriction, elevating SVR and MAP. While it can cause some reflex changes, such as a rise in heart rate in some patients, the central aim is to improve vascular tone and pressure, not to increase heart rate.

The other statements aren’t aligned with the primary goal: increasing heart rate is not the main mechanism and can raise myocardial oxygen demand; decreasing afterload would worsen blood pressure and perfusion in shock; diuresis would reduce preload and organ perfusion.