الفهرس 
Acknowledgement
Fluid ResponsivenessOnly 14 pages are availabe for public view
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Abstract
Fluid resuscitation has the potential to restore tissue perfusion to vital end organs in critically ill patients with hypotension and shock. The question of whether the patient improves with fluid, additional vasopressors or inotropes can be difficult to answer. The gold standard for assessing fluid responsiveness to guide fluid administration in critically ill patients is to perform a fluid challenge. The current study was prospectively performed at Critical Care Unit, Assiut University. It was conducted in period from January 2018 to January 2019. It included 120 patients aiming to compare between the impact of echocardiography guided fluid resuscitation and clinically guided fluid resuscitation on critically ill patients in hospital outcome. Patients were divided into two groups; they were randomized to echocardiography guided fluid resuscitation group (cases group) and clinically guided fluid resuscitation (control group). Baseline demographic; name, age, sex, smoking status, history of chronic diseases and history of drug intake, clinical data; general examination including; arterial blood pressure, pulse pressure, respiratory rate, temperature, urine output, thorough chest and cardiac examination, laboratory data; lactic acid, arterial blood pH, arterial oxygen saturation, serum creatinine and BUN, prothrombin time and concentration, serum sodium and potassium were assessed in both groups. It was noticed significant difference between two groups regarding in hospital mortality (30% in cases and 43% in controls), incidences of pulmonary edema, mechanical ventilation and intubation and cost of fluids given. So, we recommend; in any adult patient presented by shock, fluid therapy must be guided by dynamic methods and one of them is echocardiographic guided fluid administration.