الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Sepsis is a clinical syndrome of life-threatening organ dysfunction caused by a dysregulated response to infection. In septic shock, there is critical reduction in tissue perfusion; acute failure of multiple organs, including the lungs, kidneys, and liver, can occur. Common causes in immunocompetent patients include many different species of gram-positive and gram-negative bacteria. Immunocompromised patients may have uncommon bacterial or fungal species as a cause. Signs include fever, hypotension, oliguria, and confusion. Diagnosis is primarily clinical combined with culture results showing infection; early recognition and treatment is critical. Treatment is aggressive fluid resuscitation, antibiotics, surgical excision of infected or necrotic tissue and drainage of pus, and supportive care.
The aim of the current observational cohort study is to identify the prevalence and prognostic impact of sodium imbalance on sepsis and septic shock patients who admitted to the Critical Care Unit, Internal Medicine Department, Assiut University in the period from the 1st of November 2020 up to the end of November 2021.
The study included 80 patients with sepsis or septic shock, with a mean age of 63.35 ±11.57 years and ranged from 34 up to 89 years, with slight male sex predominance (male-to-female ratio of 1.4:1).
According to the serum sodium level, the studied participants were divided into two groups; 50 patients with sodium imbalance either hyper or hyponatremia (serve as cases), and 30 patients with eunatremia (serve as controls).
The results of our present study can be summarized as follows:
The mean heart rate and the total leucocytic count were significantly higher among the studied cases compared to matched controls.
Chest infection was the commonest cause of sepsis, followed by genitourinary infection
Klebseilla pneumonia was the commonest pathogen that was isolated from 27.5% of the studied participants, followed by Pseudomonus in 21.3%, and staph in 15.0%.
qSOFA Score ≥ 2 was significantly higher among the studied cases.
The studied cases were suffered from longer hospital stay and poorer outcome compared to matched controls.
High body temperature, increased heart rate, high total leucocytic count, lower SBP, lower GCS score, higher SOFA score, and sodium imbalance (either hypo or hypernatremia) at baseline were significant predictors for poor prognosis.