{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:03:17Z","timestamp":1789524197581,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T00:00:00Z","timestamp":1614384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and Objective<\/jats:title><jats:p>To identify clinical indicators of septic shock in critical care patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>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 investigate the subject in different realities such as that of Brazil.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The study had a cross\u2010sectional design based on STROBE guidelines (see Appendix <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#jocn15713-sup-0001\">S1<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of 392 patients with sepsis or septic shock was admitted to the Intensive Care Unit of a Brazilian university hospital. Data were collected from medical records of the Intrahospital Sepsis Combat Program referring to patients admitted between January 2018\u2013January 2019. 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 analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of the total sample, 190 (49%) patients were admitted with septic shock. Clinical indicators of septic shock were hypotension, mechanical ventilation, lactate levels between 2.0\u20133.9 or &gt;4, hypothermia &lt;36\u00b0C, radiotherapy\u2010associated chemotherapy, Sequential Organ Failure Assessment score &gt;3 and admittance through the emergency unit. Among patients with septic shock, 85 (44.7%) were discharged and 105 (55.2%) died in the intensive care unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with septic shock presented hyperlactataemia and greater organic dysfunction as clinical indicators when compared to patients with sepsis. Mechanical ventilation, chemotherapy and radiotherapy increased the risk of developing septic shock.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>Our results can support the nursing team by providing the main clinical indicators of septic shock and contributing to the interprofessional team in the prevention of septic shock.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15713","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T13:39:50Z","timestamp":1613482790000},"page":"1607-1614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Septic shock: Clinical indicators and implications to critical patient care"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4650-5587","authenticated-orcid":false,"given":"Luciana","family":"Ramos Corr\u00eaa Pinto","sequence":"first","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre Rua Ramiro Barcelos Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina de Oliveira","family":"Azzolin","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul (UFRGS School of Nursing, Postgraduate Program Rua S\u00e3o Manoel Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9068-7189","authenticated-orcid":false,"given":"Am\u00e1lia de F\u00e1tima","family":"Lucena","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul (UFRGS School of Nursing, Postgraduate Program Rua S\u00e3o Manoel Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriane M. S.","family":"Moretti","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre Rua Ramiro Barcelos Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaqueline S.","family":"Haas","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre Rua Ramiro Barcelos Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael B.","family":"Moraes","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas de Porto Alegre Rua Ramiro Barcelos Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilberto","family":"Friedman","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul (UFRGS Postgraduate Program in Pneumological Sciences Rua Ramiro Barcelos Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-015-0058-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827e83af"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2018.02.012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/2177-9465-ean-2019-0013"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2016.03.021"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.0131"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201310-1875OC"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000050454.01978.3B"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30322-5"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5935\/0103-507X.20160068"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.13836"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-017-4683-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nuf.12408"},{"issue":"1","key":"e_1_2_10_15_1","first-page":"9","article-title":"An epidemiological study of sepsis in intensive care units. 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