الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Both inadequate fluid resuscitation and volume overload are hazardous to patients, and nowadays it is well recognized in many literatures that both affect prognosis of critically ill Patients (255).It is essential also to have effective tools that discriminate fluid responders from non -fluid responders (10,11).Many dynamic markers of fluid responsiveness have been studied in recent years in many studies to predict who will benefit from fluid challenge (11,12,13,14,15).One of the most important dynamic markers is passive leg rising maneuver as it is physiological and highly sensitive (7).When passive leg rising is combined with non- invasive maneuvers to predict COP or tracking stroke volume, its sensitivity and specificity will be increased (12).We had investigated the accuracy of ET-CO2 in assessment of fluid responsiveness in critically ill spontaneously breathing shocked patients. We also have evaluated the accuracy of ET-CO2 in comparison to percent of change in COP post PLR maneuver using LVOT/VTI technique as a simple easy method in hemodynamic evaluation of critically ill patients.The study was conducted on 40 critically ill septic and hypovolemic shocked patients admitted to Critical Care Department of Beni-Suef University Hospitals. Two sets of measurements of hemodynamic variables (HR, RR, non-invasive MAP), Echocardiographic data variables (LVOT VTI, LVOT SV, COP) and ET-CO2 variables were obtained in the semi-recumbent position and 90 seconds post PLR. In our study we found that the prevalence of response to PLR was 55% from all participants. We also found that among responders, there was no significant positive linear correlation between the ETCO2 at baseline after PLR and its rate of increase with cardiac output.We also found that at a cut off 8.01% percent of change from baseline to after PLR or of baseline ET CO2 could predict fluid responsiveness after PLR with 81.8% sensitivity and 72.2% specificity. The absolute difference in end tidal CO2 ≥ 2.5mmHg has a significant role in prediction of responsiveness (P-value<0.001).