LUCAS DE MACEDO DOS SANTOS

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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Autor: GOULARDINS, Juliana Barbosa ×

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  • article 2 Citação(ões) na Scopus
    Noninvasive Neuromodulation Techniques in Difficult Tracheostomy Weaning of Patients With Spinal Cord Injury Report of Two Cases
    (2021) CARVALHO, Priscila De; GOULARDINS, Juliana Barbosa; SOUSA, Danilo Miyoji Nakamura de; BARBOSA, Cristiane Marcela da Silva; CAETANO, Thabata Cristina Candido; SANTOS, Lucas de Macedo dos; ITO, Clara Hikari; HIROTA, Adriana Sayuri; PEREIRA, Rita Pavione Rodrigues; BAPTISTA, Abrahao Fontes; TANAKA, Clarice
    High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.
  • conferenceObject
    Transcranial direct current stimulation and cough effectiveness in SCI patients: case report
    (2020) CARVALHO, Priscila de; HIROTA, Adriana Sayuri; SANT'ANNA, Guadalupe Nery; GOULARDINS, Juliana Barbosa; SANTOS, Lucas Macedo; CAETANO, Thabata; ITO, Clara Hikari; MOL, Caroline Gomes; RODRIGUES, Rita Pavione; BAPTISTA, Abrahao Fontes; TANAKA, Clarice