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Abstract
This study was conducted in surgical ICU in cairo university hospitals to detect the accuracy of new ultrasound indices (IVC caval index, IJV / CCA cross sectional area and IJV aspect ratio) to guide fluid therapy and predict fluid responsiveness (assessed by trans-thoracic echocardiography) in severe sepsis and septic shock spontaneously breathing patients in comparison to traditional CVP measurement. The results of this study showed that the minimum IVC diameter, caval index, IJV area and the ratio IJV/CCA are good predictors of fluid responsiveness. These parameters were significantly different between the two groups of fluid responders and non -responders. A minimum IVC diameter of 0.9cm predicted fluid responsiveness with a sensitivity of 100% and specificity of 70%. A caval index of 35% had 92% sensitivity and 86% specificity. An IJV area of 0.9 cm2 and IJV/CCA ratio of 1.7 had a sensitivity of 85% in predicting fluid responders and a specificity of 70% and 62% respectively