الفهرس 
Overview on SepsisOnly 14 pages are availabe for public view
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Abstract
Severe sepsis and septic shock are affecting millions of people around the world each year. They are the commonest causes of morbidity and mortality in intensive care.
Early diagnosis of sepsis is the key for improving the survival. Culture is the diagnostic tool but the microbiological origin of infection is demonstrated in about 2/3rd of cases. Biomarkers have an important place in this process because they can indicate the presence or absence of sepsis and detect cause of infection. They are also important in evaluating the response to therapy and recovery from sepsis.
Lactate level may be very useful for assessing critical patients, especially those with sepsis. However, one single lactate level is not as valuable as serial lactate levels throughout the course of sepsis.
Lactate is the end product of anaerobic glycolysis which occur under hypoxic conditions in hypo perfused tissues during severe sepsis or septic shock. It is normally metabolized in liver mainly (60%). Kidneys and heart also participate in its metabolism. But in patients with septic shock, the previously mentioned organs are hypoperfused and lactate accumulates in blood and its clearance depends on reversal of hypoxic conditions.
The aim of this work was to find a correlation between the lactate clearance and mortality in patients with severe sepsis.
The study was carried out on 60 adult critically ill patients of both sexes with severe sepsis, who were admitted to the unit of Critical Care Unit in Ain Shams University Hospital.
All participants were subjected to the following: detailed history, full laboratory and radiological investigations to diagnose sepsis includes lactate level on presentation (0 hour), after 6 hours and after 24 hours, then lactate clearance is calculated and patients are divided to lactate clearance group and non-clearance group.
The study showed that clearance patients significantly had lower mortality rate, SOFA score, vasopressor therapy duration, ventilation need and hospital stay days than the non-clearance patients.