ADRIANA SAYURI HIROTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
26 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 26
- Determinants of Oxygen and Carbon Dioxide Transfer during Extracorporeal Membrane Oxygenation in an Experimental Model of Multiple Organ Dysfunction Syndrome(2013) PARK, Marcelo; COSTA, Eduardo Leite Vieira; MACIEL, Alexandre Toledo; SILVA, Debora Prudencio e; FRIEDRICH, Natalia; BARBOSA, Edzangela Vasconcelos Santos; HIROTA, Adriana Sayuri; SCHETTINO, Guilherme; AZEVEDO, Luciano Cesar PontesExtracorporeal membrane oxygenation (ECMO) has gained renewed interest in the treatment of respiratory failure since the advent of the modern polymethylpentene membranes. Limited information exists, however, on the performance of these membranes in terms of gas transfers during multiple organ failure (MOF). We investigated determinants of oxygen and carbon dioxide transfer as well as biochemical alterations after the circulation of blood through the circuit in a pig model under ECMO support before and after induction of MOF. A predefined sequence of blood and sweep flows was tested before and after the induction of MOF with fecal peritonitis and saline lavage lung injury. In the multivariate analysis, oxygen transfer had a positive association with blood flow (slope = 66, p<0.001) and a negative association with premembrane PaCO2 (slope = -0.96, P = 0.001) and SatO(2) (slope = 21.7, p<0.001). Carbon dioxide transfer had a positive association with blood flow (slope = 17, p<0.001), gas flow (slope = 33, p<0.001), pre-membrane PaCO2 (slope = 1.2, p<0.001) and a negative association with the hemoglobin (slope = -3.478, P = 0.042). We found an increase in pH in the baseline from 7.50[7.46,7.54] to 7.60[7.55,7.65] (p<0.001), and during the MOF from 7.19[6.92,7.32] to 7.41[7.13,7.5] (p<0.001). Likewise, the PCO2 fell in the baseline from 35 [32,39] to 25 [22,27] mmHg (p<0.001), and during the MOF from 59 [47,91] to 34 [28,45] mmHg (p<0.001). In conclusion, both oxygen and carbon dioxide transfers were significantly determined by blood flow. Oxygen transfer was modulated by the pre-membrane SatO(2) and CO2, while carbon dioxide transfer was affected by the gas flow, pre-membrane CO2 and hemoglobin.
- Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome(2018) TOUFEN JUNIOR, Carlos; SANTIAGO, Roberta R. De Santis; HIROTA, Adriana S.; CARVALHO, Alysson Roncally S.; GOMES, Susimeire; AMATO, Marcelo Brito Passos; CARVALHO, Carlos Roberto RibeiroBackgroundAcute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide type III procollagen (NT-PCP-III) and driving pressure during protective mechanical ventilation. It was a secondary analysis of data from randomized controlled trial that included patients with moderate/severe ARDS with at least one follow-up visit performed. We obtained serial measurements of plasma NT-PCP-III levels. Whole-lung computed tomography analysis and pulmonary function test were performed at 1 and 6months of follow-up. A health-related quality of life survey after 6months was also performed.ResultsThirty-three patients were enrolled, and 21 patients survived after 6months. In extubation day an association between driving pressure and NT-PCP-III was observed. At 1 and 6months forced vital capacity (FVC) was negatively correlated to driving pressure (p<0.01). At 6months driving pressure was associated with lower FVC independently on tidal volume, plateau pressure and baseline static respiratory compliance after adjustments (r(2)=0.51, p=0.02). There was a significant correlation between driving pressure and lung densities and nonaerated/poorly aerated lung volume after 6months. Driving pressure was also related to general health domain of SF-36 at 6months.ConclusionEven in patients ventilated with protective tidal volume, higher driving pressure is associated with worse long-term pulmonary function and structure.
- Challenges in patients supported with extracorporeal membrane oxygenation in Brazil(2012) MENDES, Pedro Vitale; MOURA, Ewandro; BARBOSA, Edzangela Vasconcelos Santos; HIROTA, Adriana Sayuri; SCORDAMAGLIO, Paulo Rogerio; AJJAR, Fabiana Maria; COSTA, Eduardo Leite Vieira; AZEVEDO, Luciano Cesar Pontes; PARK, Marcelo
bookPart Desmame da ventilação mecânica(2020) NASSAR JUNIOR, Antonio Paulo; HIROTA, Adriana Sayuri- Follow-up after acute respiratory distress syndrome caused by influenza a (H1N1) virus infection(2011) TOUFEN JR., Carlos; COSTA, Eduardo Leite V.; HIROTA, Adriana Sayuri; LI, Ho Yeh; AMATO, Marcelo Brito Passos; CARVALHO, Carlos Roberto RibeiroBACKGROUND: There are no reports on the long-term follow-up of patients with swine-origin influenza A virus infection that progressed to acute respiratory distress syndrome. METHODS: Four patients were prospectively followed up with pulmonary function tests and high-resolution computed tomography for six months after admission to an intensive care unit. RESULTS: Pulmonary function test results assessed two months after admission to the intensive care unit showed reduced forced vital capacity in all patients and low diffusion capacity for carbon monoxide in two patients. At six months, pulmonary function test results were available for three patients. Two patients continued to have a restrictive pattern, and none of the patients presented with abnormal diffusion capacity for carbon monoxide. All of them had a diffuse ground-glass pattern on high-resolution computed tomography that improved after six months. CONCLUSIONS: Despite the marked severity of lung disease at admission, patients with acute respiratory distress syndrome caused by swine-origin influenza A virus infection presented a late but substantial recovery over six months of follow-up.
- The impact of obesity in hospitalized patients with COVID-19: a retrospective cohort study(2024) CARRA, Fabio Alfano; MELO, Maria Edna de; STUMPF, Matheo A. M.; CERCATO, Cintia; FERNANDES, Ariana E.; MANCINI, Marcio C.; HIROTA, Adriana; KANASIRO, Alberto Kendy; CRESCENZI, Alessandra; FERNANDES, Amanda Coelho; MIETHKE-MORAIS, Anna; BELLINTANI, Arthur Petrillo; CANASIRO, Artur Ribeiro; CARNEIRO, Barbara Vieira; ZANBON, Beatriz Keiko; PINHEIRO, Bernardo; BATISTA, Senna Nogueira; NICOLAO, Bianca Ruiz; BESEN, Bruno Adler Maccagnan Pinheiro; BISELLI, Bruno; MACEDO, Bruno Rocha De; TOLEDO, Caio Machado Gomes De; CARVALHO, Carlos Roberto Ribeiro De; MOL, Caroline Gomes; STIPANICH, Cassio; BUENO, Caue Gasparotto; GARZILLO, Cibele; TANAKA, Clarice; FORTE, Daniel Neves; JOELSONS, Daniel; ROBIRA, Daniele; COSTA, Eduardo Leite Vieira; SILVA JUNIOR, Elson Mendes Da; REGALIO, Fabiane Aliotti; SEGURA, Gabriela Cardoso; LOURO, Giulia Sefrin; MARCELINO, Gustavo Brasil; HO, Yeh-Li; FERREIRA, Isabela Argollo; GOIS, Jeison Oliveira; SILVA-JR, Joao Manoel Da; JUNIOR, Jose Otto Reusing; RIBEIRO, Julia Fray; FERREIRA, Juliana Carvalho; GALLETI, Karine Vusberg; SILVA, Katia Regina; ISENSEE, Larissa Padrao; OLIVEIRA, Larissa Santos; TANIGUCHI, Leandro Utino; LETAIF, Leila Suemi; LIMA, Ligia Trombetta; PARK, Lucas Yongsoo; NETTO, Lucas Chaves; NOBREGA, Luciana Cassimiro; HADDAD, Luciana Bertocco Paiva; HAJJAR, Ludhmila Abrahao; MALBOUISSON, Luiz Marcelo Sa; PANDOLFI, Manuela Cristina Adsuara; PARK, Marcelo; CARMONA, Maria Jose Carvalho; ANDRADE, Maria Castilho Prandini H.; SANTOS, Mariana Moreira; BATELOCHE, Matheus Pereira; SUIAMA, Mayra Akimi; OLIVEIRA, Mayron Faria de; SOUSA, Mayson Laercio; GARCIA, Michelle Louvaes; HUEMER, Natassja; MENDES, Pedro Vitale; LINS, Paulo Ricardo Gessolo; SANTOS, Pedro Gaspar Dos; MOREIRA, Pedro Ferreira Paiva; GUAZZELLI, Renata Mello; REIS, Renato Batista Dos; DALTRO-OLIVEIRA, Renato; ROEPKE, Roberta Muriel Longo; PEDRO, Rodolpho Augusto Moura; KONDO, Rodrigo; RACHED, Samia Zahi; FONSECA, Sergio Roberto Silveira Da; BORGES, Thais Sousa; FERREIRA, Thalissa; JUNIOR, Vilson Cobello; SALES, Vivian Vieira Tenorio; FERREIRA, Willaby Serafim CassaBackground Obesity is believed to be a risk factor for COVID-19 and unfavorable outcomes, although data on this remains to be better elucidated.Objective To evaluate the impact of obesity on the endpoints of patients hospitalized due to SARS-CoV-2.Methods This retrospective cohort study evaluated patients hospitalized at a tertiary hospital (Hospital das Cl & iacute;nicas da Faculdade de Medicina da USP) from March to December 2020. Only patients positive for COVID-19 (real-time PCR or serology) were included. Data were collected from medical records and included clinical and demographic information, weight and height, SAPS-3 score, comorbidities, and patient-centered outcomes (mortality, and need for mechanical ventilation, renal replacement therapy, or vasoactive drugs). Patients were divided into categories according to their BMI (underweight, eutrophic, overweight and obesity) for comparison porpoise.Results A total of 2547 patients were included. The mean age was 60.3 years, 56.2% were men, 65.2% were white and the mean BMI was 28.1 kg/m(2). SAPS-3 score was a risk factor for all patient-centered outcomes (HR 1.032 for mortality, OR 1.03 for dialysis, OR 1.07 for vasoactive drug use, and OR 1.08 for intubation, p < 0.05). Male sex increased the risk of death (HR 1.175, p = 0.027) and dialysis (OR 1.64, p < 0.001), and underweight was protective for vasoactive drug use (OR 0.45, p = 0.027) and intubation (OR 0.31, p < 0.003).Conclusion Obesity itself was not an independent factor for worse patient-centered outcomes. Critical clinical state (indirectly evaluated by SAPS-3) appears to be the most important variable related to hard outcomes in patients infected with COVID-19.
conferenceObject Lower Drive Pressure Is Associated With Better Lung Function Two And Six Months After Acute Respiratory Distress Syndrome(2014) TOUFEN, C.; SANTIAGO, R. R. S.; HIROTA, A. S.; AMATO, M. B. P.; CARVALHO, C. R. R.article 21 Citação(ões) na Scopus Monitoring of Pneumothorax Appearance with Electrical Impedance Tomography during Recruitment Maneuvers(2017) MORAIS, Caio C. A.; SANTIAGO, Roberta R. De Santis; OLIVEIRA FILHO, Jose R. B. de; HIROTA, Adriana S.; PACCE, Pedro H. D.; FERREIRA, Juliana C.; CAMARGO, Erick D. L. B.; AMATO, Marcelo B. P.; COSTA, Eduardo L. V.conferenceObject Using The Electric Activity Of The Diaphragm (eadi) To Monitor Nppv Unloading After Extubation In A Patient With Severe COPD(2014) MIETHKE-MORAIS, A.; DINIZ-SILVA, F.; ALENCAR, A. M.; MORIYA, H. T.; HIROTA, A. S.; CARUSO, P.; COSTA, E. L. V.; CARVALHO, C. R. R.; FERREIRA, J. C.conferenceObject Follow-up of surviving acute respiratory distress syndrome patients using quantitative computed tomography(2013) TOUFEN JR., Carlos; SANTIAGO, Roberta; HIROTA, Adriana; AMATO, Marcelo; CARVALHO, Carlos
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