Echocardiographic Left Ventricular End Diastolic Area Versus Carotid Artery Duplex as a Sensitive Indicator for Guiding Fluid Resuscitation in Septic Shock Patients . A Prospective Cohort Study
Fluid replacement is considered the cornerstone of hemodynamic management in critically ill patients especially in patients with septic shock. However, only about 50% of critically ill hemodynamically unstable patients are responsive to fluids. Consequently, the resuscitation of critically ill patients requires an accurate assessment of the patients' intravascular volume status and their volume responsiveness. In this study, we will compare the efficacy of carotid artery flow to echo left ventricular end diastolic volume as a predictive value for fluid resuscitation in septic shock patients.
• ▪ Age:18-50 years old
‣ Sex: both males \&females.
⁃ Patients diagnosed with septic shock according to SOFA score more than or equal 1
⁃ Presence of at least one sign of acute circulatory failure from:
• Low blood pressure (mean arterial pressure \<65 mmHg and / or systolic \<90 mmHg).
∙ Tachycardia\> 120 bpm without other obvious cause of circulatory failure.
∙ Oliguria \<1 ml / kg during the last hour suggestive of circulatory failure.
∙ Blood hyperlactatemia \> 2mmol / l without other obvious cause a systemic circulatory failure.
∙ Another sign justifying, for example vascular increase capillary refill time more than 2 seconds.