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What is The regional aerial resistance of the mesentery and kidney vessels is reduced by and explain in detail?
In hyperdynamic sepsis, the peripheral aeriolar tone and BP are low but the cardiac output is often high; therefore the vasoconstrictor noradrenaline (norepinephrine) is appropriate to restore BP, usually at the price of some reduction in cardiac output.In most cases, a vasoconstrictor such as noradrenaline (norepinephrine) is necessary to increase SVR and BP, while an inotrope (dobutamine) may be necessary to maintain cardiac output. In the later stages of severe sepsis, the essential problem is at the microcirculatory level. Oxygen uptake and utilisation are impaired due to failure of the regional distribution of flow and direct cellular toxicity despite adequate global oxygen delivery. Tissue oxygenation may be improved and aerobic metabolism sustained by reducing demand, i.e. metabolic rate. ref:Davidsson&;s principles and practices of medicine,ed 21,pg no 598