Background this prospective comparative observational study, to compare the incidence of myocardial injury in patients with hypovolemic shock versus septic shock, after approval of Ethical committee of critical care department on forty patients in general ICU divided into two groups of twenty patients each equal. Aim of the Work to compare the incidence of myocardial injury in patients with hypovolemic shock versus septic shock. Patients and Methods this prospective comparative observational study, carried out in Maadi Military Force Hospital, to compare the incidence of myocardial injury in patients with hypovolemic shock versus septic shock, after approval of Ethical committee of critical care department on forty patients in general ICU divided into two groups of twenty patients each equal. Results group A has higher values in SOFA score than in Group B, most probably due to toxins affected perfusion of organs and response to resuscitation, beside the poor cellular oxygen utilization, so clinical outcome among the two groups was twenty-four patients died in (sixteen patients in Group A and eight patients in Group B), so in our study there was a higher mortality in Group A patients (Septic shock) than Group B patients (Hypovolemic shock), The deceased patients had higher serum cTnI levels than survivors, this was concordant with Arlati and his colleagues, but there were no significant differences in cardiac troponin. Conclusion the incidence of myocardial infarction is increased in Group A (septic patients) more than Group B (hypovolemic patients), most probably due to the maldistribution of coronary blood flow which might produce, for a given level of hypotension, higher amounts of myocardial damage and, consequently, higher levels of troponin I than in hypovolemic shock.

Background Measurements of central venous pressure (CVP), pulmonary arterial catheterization, esophageal Doppler, ultrasound, and trans-esophageal echocardiography may be used to determine the volume status of critically ill patients. Appropriate interpretation of the information offered by hemodynamic monitoring requires the integration of several variables. Echocardiography is increasingly used as a first tool to identify a problem and help select initial treatment. To improve patient management and outcome, the clinician must understand the advantages and the limitations of the various tools and parameters used during ICU stay. Aim of the Work to assess the intravascular volume by comparing between IVC diameter, IVC collapsibility index by ultrasound with central venous pressure (CVP) in critically ill patients. Patients and Methods A clinical interventional study was carried out at department of intensive care at Ain Shams University hospitals – Cairo – Egypt., during a three months (from October 2017 till December 2017).This study was approved by Ethical Committee of Faculty of Medicine, Ain Shams University, including the informed consents which were obtained from either the patient or the closest family member. Results In our study the IVC Collapsibility Index correlated well with the Central Venous Pressure. The sensitivity and specificity of IVC Collapsibility to Central Venous Pressure were also found to be highly statistically significant. The change in IVC diameters were also found to be statistically significant when compared to Central Venous Pressure. Conclusion The IVC CI% can provide a useful guide for noninvasive intravascular volume status and an alternative to CVP measurement assessment in critically ill patients.