الفهرس 
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Abstract
Shock is a common problem in the emergency departments and the shocked patients needs to be carefully monitored for the fluid resuscitation and the vasopressor intake. So, their intravascular status should be assessed properly for the optimal fluid resuscitation. To do that there are several methods to be used like Central venous pressure, but it showed many complications and also it does not reflect the blood volume perfectly and due to that and the invasiveness of the procedu-res for measuring the CVP , Physicians have gone to a non-invasive , cheap and safe which is the measurement of the inferior vena cava diameter and collapsibility index by the ultrasound machine to assess the intravascular volume .Now in many emeregency departments around the world Central venous pressure and the inferior vena cava diameters and collapsibility index are ued to assess the intravascular volume in shocked patients.
This study aimed to find if there is a correlation between the central venous pressure and the inferior vena cava diamteres and the collapsibility index for their ability to assess the intravascular volume in the shocked patients.
Patients and methods This study was conducted on one hundred (100) of shocked patients attending to the Emergency Department (ED) of the Menoufia University Hospital from April 2018 to October 2019 All the patients selected according to inclusion and exclusion were clinically assessed and managed through
1. ABCDE
2. Investigations
3. Measurement of central venous pressure
4.Measurement of the IVC diameter and collapsibilityindex The results of this study within the limitations of this study shown that: The majority of our patients were males (54%) with and mean age (56.01±20.92). The most common cause of shock was septic shock (39%) then the cardiogenic shock (27%) then the hypovolemic shock (23%) then Obstructive shock (6%) then Neurogenic shock (4%) then Anaphylactic shock (1%)
The mean BMI (±SD) was 26.44±4.65 in the study group. For Respiratory Rate in the study
group, the mean (±SD) was 30.42±5.30. For Heart Rate, it ranged between 35- 130 bpm. It also shows the range of Mean arterial pressure (MAP) was from 40 bpm to 76 bpm. Regarding to Glasgow coma scale (GCS), the mean (±SD) was 14.22±1.07 which ranged from 10 to 15.
While the the mean of urinary output (±SD) was 0.418±0.203ml/kg/hr which ranged from 0ml/kg/hr to 1 m/kg/hr with median of 0.4ml/kg/hr. Regarding to capillary refill time, 55% of the patients had capillary refilling >2 seconds while 45% of the patients had capillary refilling <2 seconds. Also, the mean of Lactate (mmol/L) (±SD) was 7.62±2.61and that of Scvo2 (%) was 64.79±11.11which ranged from 36 to 90. Regarding CVP, the mean CVP (±SD) in the study group was 13.70±9.55 cmH2O mm which ranged from -2 cmH2O to 30 cmH2O with median of 14 cmH2O.-This table shows the results of arterial blood gases where the mean (±SD) of PH was 7.25±0.104, with decrease in the level of HCO3 which ranged from 4to 20 (mmol/L) and the range of the Base excess was from -30 to -5 (mmol/L).