Septic shock: Clinical indicators and implications to critical patient care.

Aims and objective To identify clinical indicators of septic shockin critical care patients. Background The identification of clinical indicators of septic shock is relevant to avoid clinical deterioration of patients with sepsis. However, the recognition of these factors, especially by the nursing team, is still deficient and reinforces the need for studies that investigatethe subject in different realities such as that of Brazil. Design The study had a cross-sectional design based on STROBE guidelines (see Supplementary file 1). Methods A sample of 392 patientswith sepsis or septic shock was admitted to the Intensive Care Unit of a Brazilian university hospital. Data were collectedfrom medical records of the Intrahospital Sepsis Combat Program referring to patients admitted between January2018 and January2019. Sociodemographic and clinical data were collected, as well as information on the time from diagnosis of sepsis or septic shock to initiation of antibiotic therapy, length of stay, and discharge or death outcomes. Data were statically analyzed. Results Out of the total sample, 190 (49%) patients were admitted with septic shock. Clinical indicators of septic shock were hypotension, mechanical ventilation, lactate levelsbetween 2.0 and3.9 or > 4, hypothermia 3, andadmittance throughthe emergencyunit. Among patients with septic shock, 85 (44.7%) were discharged and 105 (55.2%) died in the intensive care unit. Conclusions Patients with septic shock presented hyperlactatemia and greater organic dysfunction as clinical indicatorswhen compared to patients with sepsis. Mechanical ventilation, chemotherapy, and radiotherapy increased the risk of developing septic shock. Relevance to clinical practice Our results can support the nursing team byproviding the main clinical indicators of septic shock and contributingto the interprofessional team in the prevention of septic shock.