الفهرس 
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Abstract
Acute circulatory failure is one of the most familiar concerns &challenges of the intensivist. It is suggested that artifacts generated by lung ultrasound can be of help. The FALLS-protocol (Fluid Administration Limited by Lung Sonography) is a tool proposed for the management of unexplained shock, mainly using lung ultrasound. (Lichtenstein, D, et al, 2013).
LUS has the advantages of being safe, non-invasive, rapidly available, and inexpensive. Being able to detect in real time the increase of extravascular lung water (EVLW), as well as the response to excessive fluids removal. LUS may provide a valuable safety threshold to conduct fluid therapy and to optimize volume status (Brotfain E, et al, 2016).
Aim of our study: Assessment of role of lung ultrasound (FALLS-protocol) in differentiating types of shock in critically ill patients.
Our study included 50 critically ill patients from January 2020 to January 2021, admitted to medical ICU of Fayoum University Hospital with presentation of shock state yet, still not diagnosed.
All patients were subjected to full history taking including, complete clinical examination, vital signs recording, Complete set of routine laboratory tests, ECG, fast bedside echocardiography and an ultrasound machine was used to apply FALLS-protocol and measuring IVC diameter &collapsibility.
The findings of our study show our preference of FALLS-protocol in differentiating different types of shock with special concern to both hypovolemic &septic shock in directing fluid therapy in both and giving an opportunity for the intensivist to have appoint where he knows the optimum time to add vasopressors in patients with septic shock giving the patient a better management and a lesser mortality risk.