الفهرس 
Risk factors of sepsisOnly 14 pages are availabe for public view
 |  | from | 120 |  |  |
| | | from | 120 | | |
Abstract
Introduction: Sepsis is the syndrome which occurs due to dysregulated inflammatory reaction to an infection, often leading to organ failure. Circulatory abnormalities associated with sepsis lead to an imbalance between systemic oxygen delivery and oxygen demand, resulting in global tissue hypoxia and/or shock. A definitive resuscitation strategy involves goal-oriented manipulation of cardiac preload, afterload, and contractility to achieve a balance between systemic oxygen delivery and oxygen demand. End points used to confirm the achievement of such a balance include normalized values for mixed ScvO2, arterial lactate concentration, base deficit, and pH. We compared the prognostic value of achieving the ScvO2versus serum lactate endpoints during goal directed therapy of patients with severe sepsis and septic shock.
Patients and methods: Our study will include 63 of the ICU patients of Ain Shams university hospitals. All patients will receive structured resuscitation, targeting CVP, MAP, UOP, blood lactate and ScvO2. Patients will be classified into two groups, (survivals and non survivals), and will have ScvO2 and lactate measurements measurements at 0, 2, 4, 6, 12 hours intervals and every 12 hours later on.
Results: The results of this study indicate that there is no difference in survival between achieving the central venous oxygen saturation versus serum lactate endpoints during goal directed therapy of patients with severe sepsis and septic shock in the ICU.
Conclusion: During severe sepsis or septic shock, early normalization of serum lactate in the first 6hours is predictive for mortality and lactate directed therapy in the first 6 hours appeared as efficient as ScvO2 in septic patients.