الفهرس 
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Abstract
In this study, we have reviewed thoroughly different types of shock ,cardiogenic , distributive including septic, traumatic, anaphylactic shocks with pathophysiologies , different management strategies , with latest updates in management of shock, with thorough revision of different static and dynamic fluid responsiveness indices in short summary .
We have used a very well-known non- invasive tool to assess fluid response in two distinct groups of ICU patients ; septic shock & cardiogenic shock mechanically ventilated patients by using ultrasound to measure inferior vena caval distensibility index , taking minimum limit at 18 % reference in Ferrarda et al 2012 study , thirty patients in each group , with pre and post assessment of vital data and serum lactate , with limited trans thoracic ECHO / ultrasound for global contractility assessment, which showed clear correlation with volume status and fluid responsiveness , with fluid boluses ; improved tissue perfusion and vital data with increased stroke volume and cardiac output, then decreased serum lactate , urine output once still fluid responsive.
The study also compared fluid responsiveness as seen by number of fluid boluses taken in each group with clearly less fluid responsiveness in cardiogenic shock group than septic shock group .
At the end, statistical analysis compared various hemodynamic parameters and in both groups with the mean IVC distensibility index before and after fluid boluses, with comparative review of results of similar studies , showing points of correlation and difference and pitfalls that could have happened and targets of further studies we would need for more precise results.