The management of septic states includes, in addition to the specific treatment
(antimicrobials and eradication of the source), a restoration of the hemodynamic disorders
and assistance of the failing organs. In general, the restoration of hemodynamic disorders
begins first with volume expansion, followed by the use of Noepinephrine (NE) when the target
mean arterial pressure (MAP) is not reached after optimizing the intravascular volume.
Recently, several studies have supported the interest of early NE on MAP, cardiac output and
mortality. It is therefore tempting to restrict fluid administration even in the initial
phase of hemodynamic management of severe sepsis by starting NE earlier.