الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Severe sepsis is an important cause of mortality in intensive care unit (leU) patients .Despite advances in understanding the pathways involved in the development of severe sepsis and despite improvements in the management of patients with severe sepsis, the reported mortality rate still >50% ( Aygen et at ,1997). Disorders that cause significant stress to the body, either physical or psychological, stimulating HP A - axis to provide sufficient cortisol to counteract the stress and to help sustain energy substrate level (Marzouk ,1990). However the unstressed adrenal gland secrete about15:20 mg of cortisol daily but they are capable of increasing it at least 10 times in the presence of major stress. However ,200 :300 mg of cortisol must be secreted to sustain life with lesser degree of stress, its ability to respond to stress that make the adrenal cortex so critical (WiUdns ,1989) . The above considerations have triggered us to study the issue adrenocortical reserve in patients of severe sepsis due to different etiology. The present study comprised 20patients with severe sepsis of different etiology attending the Emergency Hospital Of Mansoura University with their mean age 5l.45± 16.36 years.