What is the recommended therapy for a patient with altered mental status and abdominal pain who is in septic shock?

In the context of a patient presenting with altered mental status and abdominal pain in septic shock, the primary goal is to restore hemodynamic stability and ensure adequate tissue perfusion. Norepinephrine is considered the first-line vasopressor in the management of septic shock due to its ability to effectively raise blood pressure by increasing systemic vascular resistance without significantly compromising cardiac output.

Initiating norepinephrine therapy at a dose of 0.05 mcg/kg/min aligns with established guidelines for treating septic shock. This dosage provides a starting point for augmenting mean arterial pressure and improving perfusion in critical conditions where hypotension is present.

While other options such as intravenous antibiotics and fluid resuscitation (normal saline bolus) are essential components of septic shock management and should not be neglected, the immediate priority in the setting of septic shock is to stabilize the hemodynamics, which is addressed by starting norepinephrine. Dopamine, although sometimes used, is not recommended as a first-line agent for septic shock due to its variable effects on blood pressure and the risk of arrhythmias.