الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Sepsis is a systemic disease that develops after an infectious agent invades the body. In response, the body releases a storm of inflammatory mediators, such as cytokines and interleukins, which together constitute the syndrome of the systemic inflammatory response (SIRS). These mediators, unfortunately, also reduce the myocardium function and the vascular tone, increase vascular permeability, and cause fluid leakage and hypovolemia.
These changes have a consequence on all body organs, especially the kidneys, brain, liver, lungs, and coagulation system, which results in inadequate tissue and organ perfusion, inadequate oxygen and nutrient supply, and ineffective metabolic waste disposal. If it is not treated immediately, it will cause severe cellular damage, failure of several organ systems, and finally death.
The main target for fluid resuscitation in septic shock is to improve cardiac output and tissue perfusion. A patient whose SV increases 10% after administration of fluid challenge 400:500 ml is considered to be a fluid responder. According to Frank-Starling law, any increase in preload will lead to increase SV until achieving an optimal preload, at which the SV remains relatively constant even after administration of excessive fluids. If fluid therapy does not increase SV, it may cause many complications.
Electrical cardiometry EC is considered one of the new modalities to assess fluid status in patients presenting with septic shock. EC can measure SV and CO so it can predict fluid response and the need for more fluids or not to prevent the complications of volume overload.
The aim of this work was to assess the value of electrical cardiometry in non-invasive assessment of fluid responsiveness in patients presenting with septic shock.
An observational comparative prospective cohort study was conducted on forty Patients with septic shock admitted to Critical Care Medicine Department in Alexandria University Hospitals. The duration of the study continued from 1/7/2021 till 30/6/2022.
The main results of the study revealed that:
Patients were divided into two groups; fluid responders, if SV increased more than 10% after administration of fluids and fluid non-responders if SV increased less than 10% or did not increase.
In this study the mean CO was 2.50 ± 0.26 among responders and 2.50 ± 0.34 among non-responders before fluid administration. The mean CO was 2.88 ± 0.28 among responders and 2.54 ± 0.36 among non-responders after fluid therapy. The mean difference in CO was 0.38 ± 0.12 among responders and 0.04 ± 0.09 among non-responders.
In the current study, there was a positive correlation between fluid responsiveness and shorter ICU stay.
from these results it was concluded that electrical cardiometry is an accurate tool used for assessment of fluid response in patients presenting with septic shock and to predict shorter ICU stay. Based on our results we recommend for further studies on more patients and longer period of follow up to validate its effect on mortality.