الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Sepsis is a common disease in ICUs worldwide. Many researches have been made for decades, but no specific therapy was found for sepsis till now. Early diagnosis is the most important point in sepsis management, because the patients outcome is improved by early elimination of the septic focus, the administration of a broad spectrum antibiotic together with maintaining hemodynamic stability.
Diagnosis of Septic shock depends the presence of sepsis and a persistent hypotension which leads to vasopressor administration to maintain a mean arterial pressure of ≥ 65 mmHg and a lactate level of> 2 mmol / l despite adequate volume.
Expanding volume, the first-line treatment of shock state, can be the source of a crucial therapeutic dilemma. On the one hand, the severity of the disease necessitates administration of fluids rapidly and massively. On the other hand, it has now been clearly demonstrated that fluid overload has bad consequences. Many static and dynamic parameters were introduced to assess the fluid responsiveness in septic shock patients such as CVP, IVC diameter, Pp% and VTI%. Each of these parameters has its own limitations that affect its use widely in ICU.
The aim of this work was to determine whether the change in tidal volume introduced to the patient on mechanical ventilation, would affect the values of pulse pressure variations (Pp%) and echocardiographic variations (VTI%) of fluid responsiveness in septic shock patients.
The present study included a total number of 60 mechanically ventilated septic shock patients in Critical Care Medicine Department of Alexandria University Hospitals. The exclusion criteria included in the study are : age under 18 years, a history of acute coronary syndrome , cardiogenic shock, obstructive shock., hypovolemic shock, or hypoxic patients with continuous need for high PEEP.
All patients included in the study were subjected to full history taking including: age, sex and past medical history. In addition to complete physical examination which include vital signs.