MARIA JOSE CARVALHO CARMONA

(Fonte: Lattes)
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Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
    Lack of knowledge on acute stroke in children, adolescents and adults from public schools
    (2021) SALLES, I. C.; GOUVEA, G. B.; CALDERARO, M.; MONTEIRO, V. S.; CORREA, R. F.; SILVA, S. N. M. F.; SHINOHARA, H. N. I.; UMEDA, I. I. K.; AIKAWA, P.; CARVALHO, H. B.; MANSUR, A. P.; CARMONA, M. J. C.; SEMERARO, F.; BOTTIGER, B. W.; NAKAGAWA, N. K.
  • article 31 Citação(ões) na Scopus
    Up to 206 Million People Reached and Over 5.4 Million Trained in Cardiopulmonary Resuscitation Worldwide: The 2019 International Liaison Committee on Resuscitation World Restart a Heart Initiative
    (2020) BOETTIGER, Bernd W.; LOCKEY, Andrew; AICKIN, Richard; CARMONA, Maria; CASSAN, Pascal; CASTREN, Maaret; RAO, S. S. C. Chakra; CAEN, Allan De; ESCALANTE, Raffo; GEORGIOU, Marios; HOOVER, Amber; KERN, Karl B.; KHAN, Abdul Majeed S.; LEVI, Cianna; LIM, Swee H.; NADKARNI, Vinay; NAKAGAWA, Naomi V.; NATION, Kevin; NEUMAR, Robert W.; NOLAN, Jerry P.; MELLIN-OLSEN, Jannicke; PAGANI, Jacopo; SALES, Monica; SEMERARO, Federico; STANTON, David; TOPORAS, Cristina; GROOTVEN, Heleen van; WANG, Tzong-Luen; WIJESURIYA, Nilmini; WONG, Gillian; PERKINS, Gavin D.
    Sudden out-of-hospital cardiac arrest is the third leading cause of death in industrialized nations. Many of these lives could be saved if bystander cardiopulmonary resuscitation rates were better. ""All citizens of the world can save a life-CHECK-CALL-COMPRESS."" With these words, the International Liaison Committee on Resuscitation launched the 2019 global ""World Restart a Heart"" initiative to increase public awareness and improve the rates of bystander cardiopulmonary resuscitation and overall survival for millions of victims of cardiac arrest globally. All participating organizations were asked to train and to report the numbers of people trained and reached. Overall, social media impact and awareness reached up to 206 million people, and >5.4 million people were trained in cardiopulmonary resuscitation worldwide in 2019. Tool kits and information packs were circulated to 194 countries worldwide. Our simple and unified global message, ""CHECK-CALL-COMPRESS,"" will save hundreds of thousands of lives worldwide and will further enable many policy makers around the world to take immediate and sustainable action in this most important healthcare issue and initiative.
  • article 2 Citação(ões) na Scopus
    Microvascular lung vessels obstructive thromboinflammatory syndrome in patients with COVID-19: Insights from lung intravascular optical coherence tomography
    (2023) HAJJAR, Ludhmila Abrahao; ANCONA, Marco B.; KALIL FILHO, Roberto; TRESOLDI, Moreno; CALDAS, Jose Guilherme; MONTI, Giacomo; CARNEVALE, Francisco Cesar; COBELLI, Francesco De; ASSIS, Andre Moreira de; CICERI, Fabio; LANDONI, Giovanni; DIJKSTRA, Jouke; MORONI, Francesco; ABIZAID, Alexandre Antonio Cunha; UNGARETTI, Fernanda Willemann; CARMONA, Maria Jose Carvalho; BACKER, Daniel De; POMPILIO, Carlos Eduardo; JR, Fabio S. de Britto; CAMPOS, Carlos M.; ZANGRILLO, Alberto; MONTORFANO, Matteo
    Background Microvascular lung vessels obstructive thromboinflammatory syndrome has been proposed as a possible mechanism of respiratory failure in COVID-19 patients. However, it has only been observed in post-mortem studies and has never been documented in vivo, probably because of a lack of CT scan sensitivity in small pulmonary arteries. The aim of the present study was to assess the safety, tolerability, and diagnostic value of optical coherence tomography (OCT) for the assessment of patients with COVID-19 pneumonia for pulmonary microvascular thromboinflammatory syndrome.Methods The COVID-OCT trial was a multicenter, open-label, prospective, interventional clinical study. Two cohorts of patients were included in the study and underwent pulmonary OCT evaluation. Cohort A consisted of patients with COVID-19 with a negative CT scan for pulmonary thrombosis and elevated thromboinflammatory markers (D-dimer > 10,000 ng/mL or 5,000 < D-dimer < 10,000 ng/mL and one of: C-reactive Protein > 100 mg/dL, IL-6 > 6 pg/mL, or ferritin > 900 ng/L). Cohort B consisted of patients with COVID-19 and a CT scan positive for pulmonary thrombosis. The primary endpoints of the study were: (i) to evaluate the overall safety of OCT investigation in patients with COVID-19 pneumonia, and (ii) to report on the potential value of OCT as a novel diagnostic tool for the diagnosis of microvascular pulmonary thrombosis in COVID-19 patients.Results A total of 13 patients were enrolled. The mean number of OCT runs performed in each patient was 6.1 +/- 2.0, both in ground glass and healthy lung areas, achieving a good evaluation of the distal pulmonary arteries. Overall, OCT runs identified microvascular thrombosis in 8 patients (61.5%): 5 cases of red thrombus, 1 case of white thrombus, and 2 cases of mixed thrombus. In Cohort A, the minimal lumen area was 3.5 +/- 4.6 mm(2), with stenosis of 60.9 +/- 35.9% of the area, and the mean length of thrombus-containing lesions was 5.4 +/- 3.0 mm. In Cohort B, the percentage area obstruction was 92.6 & PLUSMN; 2.6, and the mean thrombus-containing lesion length was 14.1 +/- 13.9 mm. No peri-procedural complications occurred in any of the 13 patients.Conclusion OCT appears to be a safe and accurate method of evaluating the distal pulmonary arteries in hospitalized COVID-19 patients. Here, it enabled the first in vivo documentation of distal pulmonary arterial thrombosis in patients with elevated thromboinflammatory markers, even when their CT angiogram was negative for pulmonary thrombosis.
  • article 19 Citação(ões) na Scopus
    Effectiveness of the 40-Minute Handmade Manikin Program to Teach Hands-on Cardiopulmonary Resuscitation at School Communities
    (2021) NAKAGAWA, Naomi K.; OLIVEIRA, Katia M. G.; LOCKEY, Andrew; SEMERARO, Federico; AIKAWA, Priscila; MACCHIONE, Mariangela; CARVALHO-OLIVEIRA, Regiani; GOUVEA, Gabriela B.; BOAVENTURA, Ana Paula; I, Adalgisa Maiworm; CALDERARO, Marcelo; HAJJAR, Ludhmila A.; V, Eduardo Motta; SOUZA, Heraldo P.; ANDRE, Carmen D. S. de; SILVA, Luiz F. F.; POLASTRI, Thatiane F.; TIMERMAN, Sergio; CARMONA, Maria Jose C.; BOETTIGER, Bernd W.
    Bystander training in cardiopulmonary resuscitation (CPR) is crucial to improve the victims' survival and quality of life after sudden cardiac arrest. This observational study aimed to determine the success rate of 2 different programs of CPR training for children, adolescents, and adults in school communities. We assessed the development and acquisition of the following CPR skills checking local safety, assessing victim's responsiveness, calling for help, assessing victim's breathing, and performing chest compression (hands and straight arms placement on the chest, compression velocity, depth, and chest release) using a 40-minute program with handmade manikins or the 120-minute program using intermediate-fidelity manikins. There were 1,630 learners (mean age 16 years, 38% male) in the 40-minute program, and 347 learners (mean age 27 years, 32% male) in the 120-minute program. The lowest successful pass rate of learners that developed CPR skills was 89.4% in the 40-minute program and 84.5% in the 120-minute program. The chances of success increased with age in the same program (compression rate and depth). The success rate also increased with the more extended and intermediate-cost program at the same age (assessing victim's responsiveness, calling for help, and assessing the victim's respiration). In conclusion, a 40-minute and cheaper (low-cost handmade manikin) CPR program was adequate to develop and acquire the overall CPR skills for >= 89% at school communities, independently of gender. However, some individual CPR skills can be further improved with increasing age and using the longer and intermediate-cost program.
  • article 3 Citação(ões) na Scopus
    CPR Quality Assessment in Schoolchildren Training
    (2022) OLIVEIRA, Katia M. G.; CARMONA, Maria Jose C.; MANSUR, Antonio P.; TAKADA, Julio Y.; FIJACKO, Nino; SEMERARO, Federico; LOCKEY, Andrew; BOETTIGER, Bernd W.; NAKAGAWA, Naomi K.
    Whilst CPR training is widely recommended, quality of performance is infrequently explored. We evaluated whether a checklist can be an adequate tool for chest compression quality assessment in schoolchildren, compared with a real-time software. This observational study (March 2019-2020) included 104 schoolchildren with no previous CPR training (11-17 years old, 66 girls, 84 primary schoolchildren, 20 high schoolchildren). Simultaneous evaluations of CPR quality were performed using an observational checklist and real-time software. High-quality CPR was determined as a combination of 70% correct maneuvers in compression rate (100-120/min), depth (5-6 cm), and complete release, using a real-time software and three positive performance in skills using a checklist. We adjusted a multivariate logistic regression model for age, sex, and BMI. We found moderate to high agreement percentages in quality of CPR performance (rate: 68.3%, depth: 79.8%, and complete release: 91.3%) between a checklist and real-time software. Only 38.5% of schoolchildren (similar to 14 years-old, similar to 54.4 kg, and similar to 22.1 kg/m(2)) showed high-quality CPR. High-quality CPR was more often performed by older schoolchildren (OR = 1.43, 95%IC:1.09-1.86), and sex was not an independent factor (OR = 1.26, 95%IC:0.52-3.07). For high-quality CPR in schoolchildren, a checklist showed moderate to high agreement with real-time software. Better performance was associated with age regardless of sex and BMI.
  • article 1 Citação(ões) na Scopus
    Restrictive versus Liberal Fluid Therapy for Post-Cesarean Acute Kidney Injury in Severe Preeclampsia: a Pilot Randomized Clinical Trial
    (2020) SILVA, Wallace Andrino da; VARELA, Carlo Victor A.; PINHEIRO, Aline Macedo; SCHERER, Paula Castro; FRANCISCO, Rossana P. V.; TORRES, Marcelo Luis Abramides; CARMONA, Maria Jose C.; BLIACHERIENE, Fernando; ANDRADE, Lucia C.; PELOSI, Paolo; MALBOUISSON, Luiz Marcelo S.
    OBJECTIVES: The aim of this study was to determine whether a restrictive compared to a liberal fluid therapy will increase postoperative acute kidney injury (AKI) in patients with severe preeclampsia. METHODS: A total of 46 patients (mean age, 32 years; standard deviation, 6.8 years) with severe preeclampsia were randomized to liberal (1500 ml of lactated Ringer's, n=23) or restrictive (250 ml of lactated Ringer's, n=23) intravenous fluid regimen during cesarean section. The primary outcome was the development of a postoperative renal dysfunction defined by AKI Network stage >= 1. Serum cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) were evaluated at postoperative days 1 and 2. ClinicalTrials.gov: NCT02214186. RESULTS: The rate of postoperative AKI was 43.5% in the liberal fluid group and 43.5% in the restrictive fluid group (p=1.0). Intraoperative urine output was higher in the liberal (116 ml/h, IQR 69-191) than in the restrictive fluid group (80 ml/h, IQR 37-110, p < 0.05). In both groups, serum cystatin C did not change from postoperative day 1 compared to the preoperative period and significantly decreased on postoperative day 2 compared to postoperative day 1 (p<0.05). In the restrictive fluid group, NGAL levels increased on postoperative day 1 compared to the preoperative period (p <0.05) and decreased on postoperative day 2 compared to postoperative day 1 (p < 0.05). CONCLUSION: Among patients with severe preeclampsia, a restrictive fluid regimen during cesarean section was not associated with increased postoperative AKI.
  • article 12 Citação(ões) na Scopus
    KIDS SAVE LIVES BRAZIL: A successful pilot program to implement CPR at primary and high schools in Brazil resulting in a state law for a training CPR week
    (2019) NAKAGAWA, N. K.; SILVA, L. M.; CARVALHO-OLIVEIRA, R.; OLIVEIRA, K. M. G.; SANTOS, F. R. A.; CALDERARO, M.; SOUZA, H. P.; HAJJAR, L. A.; MOTTA, E. V.; TEIXEIRA, P. W. G. N.; TIMERMAN, S.; SEMERARO, F.; CARMONA, M. J. C.; BOETTIGER, B. W.
  • article 16 Citação(ões) na Scopus
    Computed tomography assessment of lung structure in patients undergoing cardiac surgery with cardiopulmonary bypass
    (2011) RODRIGUES, R. R.; SAWADA, A. Y.; ROUBY, J. -J.; FUKUDA, M. J.; NEVES, F. H.; CARMONA, M. J.; PELOSI, P.; AULER, J. O.; MALBOUISSON, L. M. S.
    Hypoxemia is a frequent complication after coronary artery bypass graft (CABG) with cardiopulmonary bypass (CPB), usually attributed to atelectasis. Using computed tomography (CT), we investigated postoperative pulmonary alterations and their impact on blood oxygenation. Eighteen non-hypoxemic patients (15 men and 3 women) with normal cardiac function scheduled for CABG under CPB were studied. Hemodynamic measurements and blood samples were obtained before surgery, after intubation, after CPB, at admission to the intensive care unit, and 12, 24, and 48 h after surgery. Pre- and postoperative volumetric thoracic CT scans were acquired under apnea conditions after a spontaneous expiration. Data were analyzed by the paired Student t-test and one-way repeated measures analysis of variance. Mean age was 63 +/- 9 years. The PaO(2)/FiO(2) ratio was significantly reduced after anesthesia induction, reaching its nadir after CPB and partially improving 12 h after surgery. Compared to preoperative CT, there was a 31% postoperative reduction in pulmonary gas volume (P < 0.001) while tissue volume increased by 19% (P < 0.001). Non-aerated lung increased by 253 +/- 97 g (P < 0.001), from 3 to 27%, after surgery and poorly aerated lung by 72 +/- 68 g (P < 0.001), from 24 to 27%, while normally aerated lung was reduced by 147 +/- 119 g (P < 0.001), from 72 to 46%. No correlations (Pearson) were observed between PaO(2)/FiO(2) ratio or shunt fraction at 24 h postoperatively and postoperative lung alterations. The data show that lung structure is profoundly modified after CABG with CPB. Taken together, multiple changes occurring in the lungs contribute to postoperative hypoxemia rather than atelectasis alone.
  • article 60 Citação(ões) na Scopus
    Ultrasound-guided percutaneous dilational tracheostomy versus bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients (TRACHUS): a randomized noninferiority controlled trial
    (2016) GOBATTO, Andre Luiz Nunes; BESEN, Bruno A. M. P.; TIERNO, Paulo F. G. M. M.; MENDES, Pedro V.; CADAMURO, Filipe; JOELSONS, Daniel; MELRO, Livia; CARMONA, Maria J. C.; SANTORI, Gregorio; PELOSI, Paolo; PARK, Marcelo; MALBOUISSON, Luiz M. S.
    Percutaneous dilational tracheostomy (PDT) is routinely performed in the intensive care unit with bronchoscopy guidance. Recently, ultrasound has emerged as a potentially useful tool to assist PDT and reduce procedure-related complications. An open-label, parallel, non-inferiority randomized controlled trial was conducted comparing an ultrasound-guided PDT with a bronchoscopy-guided PDT in mechanically ventilated critically ill patients. The primary outcome was procedure failure, defined as a composite end-point of conversion to a surgical tracheostomy, unplanned associated use of bronchoscopy or ultrasound during PDT, or the occurrence of a major complication. A total of 4965 patients were assessed for eligibility. Of these, 171 patients were eligible and 118 underwent the procedure, with 60 patients randomly assigned to the ultrasound group and 58 patients to the bronchoscopy group. Procedure failure occurred in one (1.7 %) patient in the ultrasound group and one (1.7 %) patient in the bronchoscopy group, with no absolute risk difference between the groups (90 % confidence interval, -5.57 to 5.85), in the ""as treated"" analysis, not including the prespecified margin of 6 % for noninferiority. No other patient had any major complication in either group. Procedure-related minor complications occurred in 20 (33.3 %) patients in the ultrasound group and in 12 (20.7 %) patients in the bronchoscopy group (P = 0.122). The median procedure length was 11 [7-19] vs. 13 [8-20] min (P = 0.468), respectively, and the clinical outcomes were also not different between the groups. Ultrasound-guided PDT is noninferior to bronchoscopy-guided PDT in mechanically ventilated critically ill patients.
  • article 4 Citação(ões) na Scopus
    World Restart a Heart 2020: How to keep a life-saving awareness campaign alive in a pandemic
    (2021) ROTT, Nadine; LOCKEY, Andrew; BOETTIGER, Bernd W.; BOUCIF, Salome; CARMONA, Maria; CASSAN, Pascal; RAO, Siddha S. C. Chakra; ESCALANTE-KANASHIRO, Raffo; GARG, Rakesh; GEORGIOU, Marios; HOOVER, Amber V.; KHAN, Abdulmajeed; LEVI, Cianna; LIM, Swee Han; MAHAJAN, Hitendra Chandrakant; MEAR, Teghan; MONSIEURS, Koenraad; NADKARNI, Vinay; NAKAGAWA, Naomi Kondo; NATION, Kevin; NEUMAR, Robert; O'SHAUGHNESSY, Krista; SALES, Monica; SEMERARO, Federico; GROOTVEN, Heleen Van; WANG, Tzong-Luen; WIJESURIYA, Nilmini