الفهرس 
Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Sepsis is associated with cardiovascular changes that may lead to development of tissue hypoperfusion. Early recognition of sepsis and tissue hypoperfusion is critical to implement appropriate hemodynamic support and prevent irreversible organ damage. End points for resuscitation need to be defined and invasive hemodynamic monitoring is usually required. Targets for hemodynamic optimization should include intravascular volume, blood pressure, and cardiac output. Therapeutic interventions aimed at optimizing hemodynamics in patients with sepsis include aggressive fluid resuscitation, the use of vasopressor agents, inotropic agents and in selected cases transfusions of blood products.
Each fluid should be considered a drug, with specific pharmacokinetic, pharmacodynamics, and adverse effect profiles, which can be carefully matched to the patient. Whichever fluid is chosen, resuscitation should be titrated to evidence based targets, combining clinical assessment, such as signs of tissue perfusion with dynamic hemodynamic monitoring. Balanced crystalloids may be preferred first choice, followed by albumin, based on their comparative safety profiles. 0.9% saline should only be used after consideration of its potential to cause harm and current evidence would suggest starches (HES) should be avoided in sepsis