الفهرس 
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Abstract
S
epsis is a dysregulated host response to infection resulting in potentially life-threatening organ dysfunction. Early recognition of ICU patients in a greater risk of development of subsequent complications helps to decrease the burden of morbidity and mortality in those patients.
The aim of this study was to assess the clinical utility of lactate clearance and arterial base deficit correction in predicting mortality in septic shock.
This study included 40 patients who developed septic shock after admission into ICU, recruited from Ain Shams University Hospital, Cairo, Egypt. The patients were followed up along the study period and divided into 2 equal groups; each of 20 patients, group I (non-survivor group): patients who were didn’t survive after development of sepsis and septic shock and group II (Survivor group): patients who patients who survived after development of sepsis and septic shock.
All the included cases were subjected to full history taking and full general and local examination. Full laboratory investigations were taken from all the cases. GCS was calculated to assess the neurological state of the patients. Serum lactate and BD were calculated for all the cases.
The results of the study showed that:
• No statistically significant difference in the basic demographic data between the cases in the two study groups.
• DM was the most common associated chronic followed by HTN. Smoking was the most common risk factor in the cases within the two groups. There was no statistically significant difference between the two groups.
• Respiratory tract infections were the most common cause of infection in both group in the non-survivors and survivors’ group respectively. UTI causes were the second most common source of infection.
• The items of general examination didn’t reveal a statistically significant difference except the median GCS in the survivor group was significantly higher than the non-survivor group (p= 0.016).
• The following laboratory parameters were statistically significant higher values in the non-survivor group as compared to the survivor group including PLTs, WBCs, BUN, serum urea, serum creatinine, positive blood culture, serum lactate and PH.
• The lactate levels didn’t reveal any statistically significant difference between the two groups at 6 hours, 12 hours and 24 hours of admission.
• Beginning from 24 hours of admission, the mean levels of serum lactate were significantly higher in the non-survivor group as compared to the survivor group.
• With the follow up, serum lactate level decreased with increase the duration of admission in the two groups.
• The base deficit values revealed statistically significant difference between the two groups at admission, 18 hours, 24 hours and 2 days of admission.
• The values revealed no significant difference at the 3rd. 4th and 5th day of admission.
• At the 6th and 7th day of admission, the base deficit started to increase again in the non-survivor group with statistically significant increase in the values as compared to the survivor group.
• The cut-off point of lactate at admission to differentiate between non-survivors from survivors was > 6.81 with 97.8% sensitivity and 95.7% specificity.
• The cut-off point of base deficit to differentiate between non-survivors from survivors was > 11.43 with 62% sensitivity and 100% specificity.