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Abstract
The high mortality rate observed in sepsis is not only related to the quality of management but it{u2019}s also related to the complex nature of the disease. Loss of autoregulation and altered regional and microvascular blood flow jeopardize both central and peripheral tissue perfusion in septic shock. The perfusion index (PI) is derived from the photoelectric plethysmographic signal of the pulse oximeter and has shown to be a reliable monitor of peripheral perfusion in critically ill patients. These findings raise an important question: Is there any tool that can predict the requirement of vasopressor therapy in patients with severe sepsis? all consecutive patients who were clinically suspected of having severe sepsis defined by the criteria of the American college of chest physicians / society of critical care medicine consensus conference; were included. Upon admission to intensive care unit (ICU), hemodynamic, central and peripheral perfusion variables were simultaneously recorded at baseline. Perfusion variables included; PI, blood lactate level, central venous oxygen saturation (ScVO2), and the difference between central venous carbon dioxide (PcvCO2) and arterial carbon dioxide (PaCO2) pressures (Pv-a CO2). The primary was the use of vasopressor which was defined as any administration of vasopressor medications within 24 hours after admission to ICU