الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Sepsis is a life threatening major health problem. Septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially cause mortality. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality. In addition to requiring early detection of sepsis and prompt initiation of antibiotics, the EGDT protocol requires invasive patient monitoring to guide resuscitation with intravenous fluids, vasopressors, red cell transfusions, and inotropes.
At present, little information is available regarding the use of other protocols for fluid resuscitation rather than EGDT in early management of septic shock patients. In this study, a protocolized resuscitation care had been used in septic shock patients to maintain hemodynamic support using carotid VTI and PLR for assessment of volume responsiveness to guide fluid administration and Percentage decline in lactate level to assess tissue oxygenation compared to EGDT.
The aim of the work was to assess the efficacy of a protocolized resuscitation care compared to traditional early goal directed therapy in early management of septic shock on short term mortality.
The current study was carried on 100 adult patients of both genders with septic shock. All patients received early fluid resuscitation, early empirical broad spectrum antibiotic therapy and mechanical ventilation if indicated. Patients were classified into two groups. group I was treated with EGDT and group II received a Protocolized resuscitation care. All patients were admitted to Emergency Department and Critical Care Units in Alexandria main university hospital.
The patients were randomized from 1 to 100 and classified into two groups according to the even and odd numbers:
• group I: (EGDT group) (n: 50): took odd numbers 1.3.5.7...99.
• group II: (Protocolized resuscitation care group) (n: 50): took the even numbers 2.4.6.8…100.
The selected patients were randomly assigned to the Protocolized resuscitation care group received fluid boluses (250 ml) if patient was volume responder (carotid VTI increase was greater than 10% with PLR) via adequate peripheral venous access .
The following results were obtained
- Regarding mortality, it was improved in Protocolized resuscitation care group rather than EGDT group but with no significant difference between the two groups.
- There was no significant decrease in duration of vasopressor use, mechanical ventilation days or ICU stay in patients received Protocolized resuscitation care as compared with patients received EGDT.