الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The systemic inflammatory response syndrome can be self-limited or can progress to severe sepsis and septic shock. Along this continuum, circulatory abnormalities (intravascular volume depletion, peripheral vasodilatation, myocardial depression, and increased metabolism) lead to an imbalance between systemic oxygen delivery and oxygen demand, resulting in global tissue hypoxia or shock. An indicator of serious illness, global tissue hypoxia is a key development preceding multiorgan failure and death. The transition to serious illness occurs during the critical “golden hours”, when definitive recognition and treatment provide maximal benefit in terms of outcome. These golden hours may elapse in the emergency department, hospital ward, or the intensive care unit. Early goal-directed therapy provides significant benefits with respect to outcome in patients with severe sepsis and septic shock.
The aim of the study was to evaluate the use of Pulse contour analysis based stroke volume variation (SVV) measured by (Flotrac system, Edwards lifesciences Medical Systems) in addition to early goal directed strategy in resuscitation of critically ill patients with sepsis syndrome.
Summary
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Our study was a prospective randomized study conducted in the department of ICU in Ain Shams University Hospitals. 60 patients (newly admitted to the ICU), with diagnosis of sepsis syndrome defined by (the criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference) were randomly divided into two groups according to the resuscitation protocols, group A received the protocol of early goal directed therapy and group B received pulse contour analysis SVV guided therapy. This study compared the influence of the two treatment algorithms of early goal-directed fluid therapy on outcome of sepsis patients.
Our study demonstrated that a treatment algorithm based on addition of functional hemodynamic flow-based parameter of preload (SVV) led to superior results compared to early goal directed strategy as regard improved survival and improved tissue oxygenation. In addition, our treatment strategy decreased the ICU length of stay, use of vasoactive agents, need for & duration of mechanical ventilation and need for ICU readmission