CLARICE TANAKA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/54 - Laboratório de Bacteriologia, Hospital das Clínicas, Faculdade de Medicina - Líder
21 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 21
- Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital(2012) YAMAUCHI, Liria Yuri; TRAVAGLIA, Teresa Cristina Francischetto; BERNARDES, Sidnei Ricardo Nobre; FIGUEIROA, Maise C.; TANAKA, Clarice; FU, CarolinaOBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5) versus four (3-7) days]; they had lower levels of pH, HCO3 and base excess, and the FiO(2) level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26) days vs. 8 (5-14) days], as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 - 19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II >= 34, an inspiratory positive airway pressure level >= 15 cmH2O and pH<7.40. CONCLUSION: The indications for noninvasive positive-pressure ventilation were quite varied. The failure group had a longer intensive care unit stay and higher mortality. Simplified Acute Physiology Score II >= 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure.
conferenceObject Occurrence Of Systemic And Pulmonary Complications In Patients Undergoingtracheostomy(2013) RAMOS, M. C. S.; SILVA, J. M.; MAFRA, M.; SILVEIRA, L.; CARRASCOSA, T.; TANAKA, C.; FU, C.conferenceObject Acute renal failure and hemodialysis increases the length of invasive mechanical ventilation, hospital stay and hospital costs in severe polytrauma patients(2013) PADOVANI, Caue; ROTTA, Bruna P.; SILVA, Janete M.; FU, Carolina; TANAKA, Claricebook Fisioterapia no complexo hospital das clínicas da FMUSP: memórias e marcos históricos(2012) MOTA, André; TARELOW, Gustavo Querodia; FU, Carolina; TANAKA, Clarice; NOZAWA, Emília; YASUKAWA, Samira Alencar- Protocol for Functional Assessment of Adults and Older Adults after Hospitalization for COVID-19(2021) GODOY, Caroline Gil de; SILVA, Erika Christina Gouveia e; OLIVEIRA, Danielle Brancolini de; GAMBETA, Amislaine Cristina; SILVA, Elizabeth Mendes da; CAMPOS, Camila Machado de; SCHMITT, Ana Carolina Basso; CARVALHO, Celso R. F.; FU, Carolina; TANAKA, Clarice; NAKAGAWA, Naomi Kondo; TOUFEN JUNIOR, Carlos; CARVALHO, Carlos Roberto Ribeiro de; HILL, Keith; POMPEU, Jose Eduardo
- Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study(2023) SILVA, E. C. G. E.; SCHMITT, A. C. B.; GODOY, C. G. de; OLIVEIRA, D. B. de; TANAKA, C.; TOUFEN, C. Jr.; CARVALHO, C. R. R. de; CARVALHO, C. R. F.; FU, C.; HILL, K. D.; POMPEU, J. E.(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients’ medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients’ reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.
- Functional Recovery Groups in Critically III COVI D-19 Patients and Their Associated Factors: From ICU to Hospital Discharge(2022) SCHUJMANN, Debora Stripari; LUNARDI, Adriana Claudia; PESO, Claudia Neri; POMPEU, Jose Eduardo; ANNONI, Raquel; MIURA, Mieko Claudia; CENSO, Caroline Maschio de; TANIGUCHI, Luzia Noriko Takahashi; REGENGA, Marisa de Moraes; CAMPOS, Elaine Cristina de; RIGHETTI, Renato Fraga; YAMAGUTI, Wellington Pereira; BRITO, Christina May Moran de; LOURENCO, Adriana; AGUERA, Sabrina Castaldi; TANAKA, Clarice; FU, CarolinaOBJECTIVES: To analyze functional recovery groups of critically ill COVID-19 survivors during their hospital stay and to identify the associated factors. DESIGN: Prospective observational multicenter study. SETTING: Demographic, clinical, and therapeutic variables were collected, and physical and functional status were evaluated. The Barthel index was evaluated at three time points: 15 days before hospitalization, at ICU discharge, and at hospital discharge from the ward. PATIENTS: Patients with functional independence before COVID-19 diagnosis were recruited from four hospitals and followed up until hospital discharge. MEASUREMENTS AND MAIN RESULTS: Three groups of functional recovery were described for 328 patients: functional independence (n = 144; 44%), which included patients who preserved their functional status during hospitalization; recovered functionality = 109; 33.2%), which included patients who showed dependence at ICU discharge but recovered their independence by hospital discharge; and functional dependency (n = 75; 22.8%), which included patients who were dependent at ICU discharge and had not recovered their functional status at hospital discharge. The factors associated with becoming functionally dependent at ICU discharge were time to out-of-bed patient mobilization (odds ratio [OR], 1.20; 95% CI, 1.11-1.29), age (OR, 1.02; 95% CI, 1.01-1.04), hyperglycemia (OR, 2.52; 95% CI, 1.56-4.07), and Simplified Acute Physiology Score (OR, 1.022; 95% CI, 1.01-1.04). Recovery to baseline independence during ward stays was associated with ICU length of stay (OR, 0.97; 95% CI, 0.94-0.99) and muscle strength (Medical Research Council test) at ICU discharge (OR, 1.13; 95% CI, 1.08-1.18). CONCLUSIONS: Age, hyperglycemia, and time for patient mobilization out of bed were independent factors associated with becoming physically dependent after their ICU stay. Recovery of physical function at hospital discharge was associated with muscle strength at ICU discharge and length of ICU stay.
- Functional impact on adults and older people after hospitalization by Covid-19(2023) OCHIAI, Gabriela Sayuri; GODOY, Caroline Gil de; SILVA, Erika Christina Gouveia E; OLIVEIRA, Danielle Brancolini de; SILVA, Elizabeth Mendes da; VIANA, Bianca de Oliveira Candido; SILVA, Juliana Magalhaes da; SOUZA, Roberta Oliveira Bueno de; SANTOS, Michelle Didone dos; CAMPOS, Camila Machado de; SCHMITT, Ana Carolina Basso; CARVALHO, Celso Ricardo Fernandes de; FU, Carolina; TANAKA, Clarice; TOUFEN JR., Carlos; CARVALHO, Carlos Roberto Ribeiro de; POMPEU, Jose EduardoBackground and Objectives Hospitalization by Covid-19 can cause persistent functional consequences after hospital discharge due to direct and indirect effects of SARS-COV-2 in several organs and systems of the body added to post-intensive care syndrome and prolonged bed rest. These impacts can lead to dependency in activities of daily living, mainly in older people due to aging process and functional decline. This study aimed to compare the effects of hospitalization by Covid-19 on functional capacity of adults and older people and to identify its associated factors. Methods Cross-sectional observational study of 159 survivors of hospitalization by Covid-19 after 1 month from discharge at Hospital das Clinicas of the University of Sao Paulo, divided into groups: adults (aged < 60 years) and older people (aged >= 60 years). Those who did not accept to participate, without availability or without ability to understand the questionnaires were excluded. Functional capacity was assessed by the Barthel Index and patients were classified according to their scores. Data analysis was performed in JASP Statistics program and the sample was compared between the age groups. Wilcoxon test was applied to compare before and after periods, Mann-Whitney test was used for between groups comparison. We adopted alpha = 0.05. Results The total Barthel Index median score was lower 1 month after hospital discharge than in the pre-Covid-19 period. Older people had worse functional status than adults before and also showed greater impairment after hospital discharge. Both groups showed lower Barthel Index classification than before, and older people presented more functional dependence than adults in both periods. Age, sarcopenia and frailty were associated factors. Discussion Hospitalization by Covid-19 impacts functional capacity after 1 month from discharge, especially in older people. Age, sarcopenia and frailty are associated factors. These results suggest need for care and rehabilitation of Covid-19 survivors.
- Relationship between availability of physiotherapy services and ICU costs(2018) ROTTA, Bruna Peruzzo; SILVA, Janete Maria da; FU, Carolina; GOULARDINS, Juliana Barbosa; PIRES-NETO, Ruy de Camargo; TANAKA, ClariceObjective: To determine whether 24-h availability of physiotherapy services decreases ICU costs in comparison with the standard 12 h/day availability among patients admitted to the ICU for the first time. Methods: This was an observational prevalence study involving 815 patients >= 18 years of age who had been on invasive mechanical ventilation (IMV) for >= 24 h and were discharged from an ICU to a ward at a tertiary teaching hospital in Brazil. The patients were divided into two groups according to h/day availability of physiotherapy services in the ICU: 24 h (PT-24; n = 332); and 12 h (PT-12; n = 483). The data collected included the reasons for hospital and ICU admissions; Acute Physiology and Chronic Health Evaluation II (APACHE II) score; IMV duration, ICU length of stay (ICU-LOS); and Omega score. Results: The severity of illness was similar in both groups. Round-theclock availability of physiotherapy services was associated with shorter IMV durations and ICU-LOS, as well as with lower total, medical, and staff costs, in comparison with the standard 12 h/day availability. Conclusions: In the population studied, total costs and staff costs were lower in the PT-24 group than in the PT-12 group. The h/day availability of physiotherapy services was found to be a significant predictor of ICU costs.
conferenceObject Functional status of patients readmitted to ICU(2013) SILVEIRA, Leda T. Y.; SILVA, Janete M.; MAFRA, Jose M. S.; RAMOS, Michele C. S.; TANAKA, Clarice; FU, Carolina
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