Objective: Aim of this study: was to compare the central venoarterial carbon dioxide 
difference/arterial-central venous oxygen difference (P(va)CO2/C(a-v)O2) ratio versus 
lactate clearance as an indicator to evaluate the steps of initial resuscitation in septic patients. 
Patients and methods: Our study was conducted in the ICU,Minia University Hospital. 
Eighty patients with severe sepsis or septic shock. Results: There was improvement in CVP, 
MAP, or Scvo2 at T8 after early resuscitation with no significant differences between group1 
and group 2 and inside each group. There were no significant difference in P(v-a)CO2/C(av)O2 ratio at T0 and at T8 at group 1. However there was higher lactate level at T0 and 
exhibited significantly lower at T8 in group 2. Conclusion: Further clinical trials are needed 
to conclusively establish lactate clearance as a resuscitation endpoint and an outcome measure 
to be targeted during the most proximal phases of severe sepsis and septic shock.