JOSE OTAVIO COSTA AULER JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina - Líder
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- Evaluation of hemodynamic effects of xenon in dogs undergoing hemorrhagic shock(2013) FRANCESCHI, Ruben C.; MALBOUISSON, Luiz; YOSHINAGA, Eduardo; AULER JR., Jose Otavio Costa; FIGUEIREDO, Luiz Francisco Poli de; CARMONA, Maria Jose C.OBJECTIVES: The anesthetic gas xenon is reported to preserve hemodynamic stability during general anesthesia. However, the effects of the gas during shock are unclear. The objective of this study was to evaluate the effect of Xe on hemodynamic stability and tissue perfusion in a canine model of hemorrhagic shock. METHOD: Twenty-six dogs, mechanically ventilated with a fraction of inspired oxygen of 21% and anesthetized with etomidate and vecuronium, were randomized into Xenon (Xe; n = 13) or Control (C; n = 13) groups. Following hemodynamic monitoring, a pressure-driven shock was induced to reach an arterial pressure of 40 mmHg. Hemodynamic data and blood samples were collected prior to bleeding, immediately after bleeding and 5, 20 and 40 minutes following shock. The Xe group was treated with 79% Xe diluted in ambient air, inhaled for 20 minutes after shock. RESULT: The mean bleeding volume was 44 mL.kg(-1) in the C group and 40 mL.kg(-1) in the Xe group. Hemorrhage promoted a decrease in both the cardiac index (p<0.001) and mean arterial pressure (p<0.001). These changes were associated with an increase in lactate levels and worsening of oxygen transport variables in both groups (p<0.05). Inhalation of xenon did not cause further worsening of hemodynamics or tissue perfusion markers. CONCLUSIONS: Xenon did not alter hemodynamic stability or tissue perfusion in an experimentally controlled hemorrhagic shock model. However, further studies are necessary to validate this drug in other contexts.
- Academic health centers: integration of clinical research with healthcare and education. Comments on a workshop(2018) ARAI, Roberto Jun; NORONHA, Irene de Lourdes; NICOLAU, Jose Carlos; SCHMIDT, Charles; ALBUQUERQUE, Gustavo Moreira de; MAHAFFEY, Kenneth W.; KRIEGER, Eduardo Moacyr; AULER JUNIOR, Jose Otavio Costa
- The past, present and future of clinical research(2011) AZEKA, Estela; FREGNI, Felipe; AULER JUNIOR, Jose Otavio Costa
- Diaphragmatic pacing stimulation in spinal cord injury: anesthetic and perioperative management(2012) TEDDE, Miguel L.; VASCONCELOS FILHO, Paulo; HAJJAR, Ludhmila Abrahao; ALMEIDA, Juliano Pinheiro de; FLORA, Gustavo Fagundes; OKUMURA, Erica Mie; OSAWA, Eduardo A.; FUKUSHIMA, Julia Tizue; TEIXEIRA, Manoel Jacobsen; GALAS, Filomena Regina Barbosa Gomes; JATENE, Fabio Biscegli; AULER JR., Jose Otavio CostaOBJECTIVE: The standard therapy for patients with high-level spinal cord injury is long-term mechanical ventilation through a tracheostomy. However, in some cases, this approach results in death or disability. The aim of this study is to highlight the anesthetics and perioperative aspects of patients undergoing insertion of a diaphragmatic pacemaker. METHODS: Five patients with quadriplegia following high cervical traumatic spinal cord injury and ventilator-dependent chronic respiratory failure were implanted with a laparoscopic diaphragmatic pacemaker after preoperative assessments of their phrenic nerve function and diaphragm contractility through transcutaneous nerve stimulation. ClinicalTrials.gov:NCT01385384. RESULTS: The diaphragmatic pacemaker placement was successful in all of the patients. Two patients presented with capnothorax during the perioperative period, which resolved without consequences. After six months, three patients achieved continuous use of the diaphragm pacing system, and one patient could be removed from mechanical ventilation for more than 4 hours per day. CONCLUSIONS: The implantation of a diaphragmatic phrenic system is a new and safe technique with potential to improve the quality of life of patients who are dependent on mechanical ventilation because of spinal cord injuries. Appropriate indication and adequate perioperative care are fundamental to achieving better results.
- Independent early predictors of mortality in polytrauma patients: a prospective, observational, longitudinal study(2017) COSTA, Luiz Guilherme V. da; CARMONA, Maria Jose C.; MALBOUISSON, Luiz M.; RIZOLI, Sandro; ROCHA-FILHO, Joel Avancini; CARDOSO, Ricardo Galesso; AULER-JUNIOR, Jose Otavio C.OBJECTIVES: Trauma is an important public health issue and associated with substantial socioeconomic impacts and major adverse clinical outcomes. No single study has previously investigated the predictors of mortality across all stages of care (pre-hospital, emergency room, surgical center and intensive care unit) in a general trauma population. This study was designed to identify early predictors of mortality in severely injured polytrauma patients across all stages of care to provide a better understanding of the physiologic changes and mechanisms by which to improve care in this population. METHODS: A longitudinal, prospective, observational study was conducted between 2010 and 2013 in Sao Paulo, Brazil. Patients submitted to high-energy trauma were included. Exclusion criteria were as follows: injury severity score <16, <18 years old or insufficient data. Clinical and laboratory data were collected at four time points: pre-hospital, emergency room, and 3 and 24 hours after hospital admission. The primary outcome assessed was mortality within 30 days. Data were analyzed using tests of association as appropriate, nonparametric analysis of variance and generalized estimating equation analysis (p<0.05). ClinicalTrials.gov: NCT01669577. RESULTS: Two hundred patients were included. Independent early predictors of mortality were as follows: arterial hemoglobin oxygen saturation (p<0.001), diastolic blood pressure (p<0.001), lactate level (p<0.001), Glasgow Coma Scale score (p<0.001), infused crystalloid volume (p<0.015) and presence of traumatic brain injury (p<0.001). CONCLUSION: Our results suggest that arterial hemoglobin oxygen saturation, diastolic blood pressure, lactate level, Glasgow Coma Scale, infused crystalloid volume and presence of traumatic brain injury are independent early mortality predictors.
- The role of Academic Health Centers in Transformative Medical Education(2019) AULER JUNIOR, Jose Otavio Costa; ALMEIDA, Talita de; KRIEGER, Eduardo Moacyr
- Transforming operating rooms into intensive care units and the versatility of the physician anesthesiologist during the COVID-19 crisis (vol 75, e2023, 2020)(2020) CARMONA, Maria Jose Carvalho; QUINTAO, Vinicius Caldeira; MELO, Brigite Feiner de; ANDRE, Rodrigo Guerson; KAYANO, Rafael Priante; PERONDI, Beatriz; MIETHKE-MORAIS, Anna; ROCHA, Marcelo Cristiano; MALBOUISSON, Luis Marcelo Sa; AULER-JUNIOR, Jose Otavio Costa
- Transforming operating rooms into intensive care units and the versatility of the physician anesthesiologist during the COVID-19 crisis(2020) CARMONA, Maria Jose Carvalho; QUINTAO, Vinicius Caldeira; MELO, Brigite Feiner de; ANDRE, Rodrigo Gherson; KAYANO, Rafael Priante; MALBOUISSON, Luiz Marcelo Sa; AULER-JUNIOR, Jose Otavio Costa
- How should health systems prepare for the evolving COVID-19 pandemic? Reflections from the perspective of a Tertiary Cancer Center(2020) CHEN, Andre Tsin Chih; MONIZ, Camila Motta Venchiarutti; RIBEIRO-JUNIOR, Ulysses; DIZ, Maria del Pilar Estevez; SALVAJOLI, Joao Victor; VASCONCELOS, Karina Gondim Moutinho Da Conceicao; AULER-JUNIOR, Jose Otavio Costa; CECCONELLO, Ivan; ABDALA, Edson; HOFF, Paulo Marcelo Gehm
- Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial(2018) AMENDOLA, Cristina Prata; SILVA-JR, Joao Manoel; CARVALHO, Taisa; SANCHES, Luciana Coelho; SILVA, Ulysses Vasconcelos de Andrade e; ALMEIDA, Rosana; BURDMANN, Emmanuel; LIMA, Emerson; BARBOSA, Fabiana Ferreira; FERREIRA, Renata Souza; CARMONA, Maria Jose C.; MALBOUISSON, Luiz Marcelo Sa; NOGUEIRA, Fernando A. M.; AULER-JUNIOR, Jose Otavio Costa; LOBO, Suzana MargarethOBJECTIVES: Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goaldirected therapy conducted during the early stages of acute kidney injury could change the course of the disease. METHODS: This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov: NCT02414906. RESULTS: A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p.0.001) compared to the control group (p.O.572). No significant differences in the change in serum creatinine level (p.0.96), persistence of acute kidney injury beyond 72h (p.0.064) or the need for renal replacement therapy (p.0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR: 0.61, 95% CI: 0.37-1.00, p=0.048, number needed to treat=5). CONCLUSIONS: Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.