Abstract Septic shock is a life-threatening syndrome characterized by circulatory failure, immune dysregulation, neuroendocrine activation, and cellular metabolic dysfunction. Norepinephrine (NE) remains the first-line vasopressor for early resuscitation because it restores vascular tone, increases mean arterial pressure, and maintains vital organ perfusion. However, emerging evidence from neuroimmunology and immunometabolism suggests that NE also acts beyond hemodynamic support.
