الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 143 |  |  |
| | | from | 143 | | |
Abstract
Shock is a potentially fatal condition of circulatory failure; it is crucial that the clinician quickly determine the etiology so that effective measures and therapy can be used. shock most frequently manifests with hypotension, but it can also be heralded through other changes in vital signs or the presence of increased plasma lactate levels. There is a spectrum of severity ranging from sepsis to septic shock, and sepsis is a clinical illness characterized by systemic inflammation brought on by infection.
Fluid resuscitation is frequently administered to individuals who are in septic shock. Normal saline is the most often utilized fluid in adult ICU patients and has been linked to acute kidney injury (AKI) as well as other issues that can lead to mortality. Crystalloid solutions are advised for the early resuscitation of sepsis.
Our study was a prospective observational study, conducted in the surgical intensive care unit of Ain Shams University Hospitals, from September 2022 to February 2023. The study was carried out on 70 adult patients at least 18 years old with no previous CKD presented with a diagnosis of sepsis or septic shock as described by surviving sepsis campaign (SSC), resuscitated with (NaCL 0.9%), who developed AKI and follow up chloride level for three days any patients were not developing AKI were excluded, Remaining patients were divided into two groups according to chloride level to determine the relation between Chloride level and AKI: group (1): hyperchloremic (CL >110), group (2): normochloemic (CL ≤110).
All Patients were subjected to the following:
I- Full history: age, gender, body weight, diabetes mellitus, hypertension, thyroid disease, cerebrovascular disease (CVD), HCV, and bronchial asthma (BA).
II- Laboratory Work-up: the blood samples were taken three consecutive times. All patients were sampled for: serum creatinine, daily urea level, daily glomerular filtration rate (GFR), and daily chloride level.
III- Clinical Assessment: daily resuscitation volume, urine osmotic pressure (UOP), arterial blood gases (ABG), daily lactate level, and daily anion gap.
IV- Severity Scores: acute physiological and chronic health evaluation (APACHE) score, and quick sequential organ failure assessment (qSOFA).
The results of our present study can be summarized as follows:
1. There was a significant relationship between clinical severity scores such as; APACHE, qSOFA score, and AKI (P≤0.001, ≤0.001) respectively.
2. An interesting result was that there was no significance to chloride in relation to AKI (P=0.11).
3. There was a significant relationship between Resuscitation volume and UOP and AKI (P≤0.001).
4. There was a significant relationship between serum Lactate level and AKI (P≤0.001).
5. There was a significant relationship between PH, HCO3, and anion gap with AKI (P≤0.001), meanwhile, there was not a significant relationship between pCo2 and AKI (P=0.21).