DENISE AYA OTSUKI
Projetos de Pesquisa
Unidades Organizacionais
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- The effect of premedication with ketamine, alone or with diazepam, on anaesthesia with sevoflurane in parrots (Amazona aestiva)(2013) PAULA, Valeria Veras; OTSUKI, Denise Aya; AULER JUNIOR, Jose Otavio Costa; NUNES, Talyta Lins; AMBROSIO, Aline Magalhaes; FANTONI, Denise TabacchiBackground: Premedication is rarely used in avian species. The aim of this study was to evaluate the effect of premedication on the quality of sevoflurane induction and anaesthesia in parrots. We hypothesised that premedication would facilitate handling and decrease the minimum anaesthetic dose (MAD). Thirty-six adult parrots were randomly distributed in three groups: group S (n = 12) was premedicated with NaCl 0.9%; group KS (n = 12) was premedicated with 10 mg.kg(-1) ketamine; and group KDS (n = 12) was premedicated with 10 mg.kg(-1) ketamine and 0.5 mg.kg(-1) diazepam, delivered intramuscularly. After induction using 4.5% sevoflurane introduced through a facemask, the MAD was determined for each animal. The heart rate (HR), respiratory rate (RR), systolic arterial blood pressure (SAP), and cloacal temperature (CT) were recorded before premedication (T0), 15 minutes after premedication (T1), and after MAD determination (T2). Arterial blood gas analyses were performed at T0 and T2. The quality of anaesthesia was evaluated using subjective scales based on animal behaviour and handling during induction, maintenance, and recovery. Statistical analyses were performed using analysis of variance or Kruskal-Wallis tests followed by Tukey's or Dunn's tests. Results: The minimal anaesthetic doses obtained were 2.4 +/- 0.37%, 1.7 +/- 0.39%, and 1.3 +/- 0.32% for groups S, KS, and KDS, respectively. There were no differences in HR, RR, or CT among groups, but SAP was significantly lower in group S. Sedation was observed in both the premedicated S-KS and S-KDS groups. There were no differences in the quality of intubation and recovery from anaesthesia among the three groups, although the induction time was significantly shorter in the pre-medicated groups, and the KS group showed less muscle relaxation. Conclusions: Ketamine alone or the ketamine/diazepam combination decreased the MAD of sevoflurane in parrots (Amazona aestiva). Ketamine alone or in combination with diazepam promoted a good quality of sedation, which improved handling and reduced the stress of the birds. All protocols provided safe anaesthesia in this avian species.
- PULSE PRESSURE VARIATION IS COMPARABLE WITH CENTRAL VENOUS PRESSURE TO GUIDE FLUID RESUSCITATION IN EXPERIMENTAL HEMORRHAGIC SHOCK WITH ENDOTOXEMIA(2013) NOEL-MORGAN, Jessica; OTSUKI, Denise Aya; AULER JR., Jose Otavio Costa; FUKUSHIMA, Julia Tizue; FANTONI, Denise TabacchiIntroduction: Pulse pressure variation (PPV) has been proposed as a promising resuscitation goal, but its ability to predict fluid responsiveness has been questioned in various conditions. The purpose of this study was to assess the performance of PPV in predicting fluid responsiveness in experimental hemorrhagic shock with endotoxemia, while comparing it with goals determined by a conventional set of guidelines. Methods: Twenty-seven pigs were submitted to acute hemorrhagic shock with intravenous infusion of endotoxin and randomized to three groups: (i) control; (ii) conventional treatment with crystalloids to achieve and maintain central venous pressure (CVP) 12 to 15 mmHg, mean arterial pressure of 65 mmHg or greater, and SvO(2) (mixed venous oxygen saturation) of 65% or greater; (iii) treatment to achieve and maintain PPV of 13% or less. Parametric data were analyzed by two-way analysis of variance and Tukey test and differences in crystalloid volumes by t test. Predictive values of variables regarding fluid responsiveness were evaluated by receiver operating characteristic curves and multiple logistic regression. Results: Both treatments produced satisfactory hemodynamic recovery, without statistical differences in fluid administration (P = 0.066), but conventional treatment induced higher CVP (P = 0.001). Areas under receiver operating characteristic curves were larger for CVP (0.77; 95% confidence interval, 0.68-0.86) and PPV (0.74; 95% confidence interval, 0.65-0.83), and these variables were further selected by multiple logistic regression as independent predictors of responsiveness. Optimal PPV cutoff was 15%, with false-positive results involving mean pulmonary arterial pressure of 27 mmHg or greater. Conclusions: Acute resuscitation guided by PPV was comparable with the strategy guided by CVP, mean arterial pressure, and SvO(2). Central venous pressure and PPV were individually limited but independently predictive of fluid responsiveness.
- Atrofia progressiva generalizada da retina em cães da raça Cocker Spaniel(2013) GOMES, Debora; OTSUKI, Denise Aya; LISAK, Ricardo; SAFATLE, Angelica de Mendonca VazGeneralized progressive retinal atrophy (GPRA) is a common disease in Cocker Spaniels dogs characterized by progressive loss of retinal function and disappearance of photoreceptors. The disease is bilateral, hereditary, autosomal recessive, has no sexual predisposition and is frequently associated with cataracts. According to molecular studies the degeneration occurs by a mutation in different genes. In American Cocker Spaniels dogs the disease is observed between three and five years of age and in English Cocker Spaniels between four and eight years old. The clinical signs are: nyctalopia, tapetal hyperreflexia and cataracts. The diagnosis is based on clinical history, ophthalmologic examination and complementary exams such as electroretinography, ocular ultrasound and genetic testing. This article aimed to conduct a review of literature on the generalized progressive retinal atrophy (GPRA) in Cocker Spaniel dogs with cataracts.
- Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia(2013) IDA, Keila K.; FANTONI, Denise T.; SOUTO, Maria T. M. R.; OTSUKI, Denise A.; ZOPPA, Andre L. V.; SILVA, Luis C. L. C.; AMBROSIO, Aline M.Objective To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Study design Prospective randomized clinical study. Animals Twenty client-owned healthy horses aged 5 +/- 2years, weighing 456 +/- 90kg. Methods In the control group (CG; n=10) weaning was performed by a gradual decrease in respiratory rate (fR) and in the PSV group (PSVG; n=10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2>50 mmHg, arterial pH<7.35 plus PaCO2>50mmHg or PaO2<60mmHg were observed at any time after disconnection from the ventilator until 30minutes after the horse stood. Threshold values for each index were established and the predictive power of these values was tested. Results Pressure support ventilation group (PSVG) had (mean +/- SD) pH 7.36 +/- 0.02 and PaCO2 41 +/- 3mmHg at weaning and the average lowest PaO2 69 +/- 6mmHg was observed 15minutes post weaning. The CG had pH 7.32 +/- 0.02 and PaCO2 57 +/- 6mmHg at weaning and the average lowest PaO2 48 +/- 5mmHg at 15minutes post weaning. No accuracy in predicting weaning effect was observed for fR (p=0.3474), minute volume (p=0.1153), SaO2 (p=0.1737) and PaO2/PAO2 (p=0.1529). A high accuracy in predicting an optimal effect of weaning was observed for VT>10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p=0.0001), VT/bodyweight>18.5mL kg-1 (p=0.0001) and PaO2/FiO2>298 (p=0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for VT<10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p= 0.0001) and PeCO238mmHg (p=0.0001) at weaning. Conclusions and clinical relevance Pressure support ventilation (PSV) weaning had a better respiratory outcome. A higher VT, VT/body weight, PaO2/FiO2 ratio and a lower fR/VT ratio and PeCO2 were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia.
conferenceObject EVALUATION OF THE CARDIAC EFFECTS OF RECOMBINANT HUMAN ACTIVATED PROTEIN C ADMINISTERED AT DIFFERENT MOMENTS IN EXPERIMENTAL SEPTIC SHOCK(2013) OTSUKI, D. A.; FANTONI, D. T.; PASQUALUCCI, C. A.; AULER, J. O.conferenceObject IMPACT OF DIFFERENT HAEMODYNAMIC RESUSCITATION STRATEGIES ON BRAIN PERFUSION AND TISSUE EDEMA MARKERS IN A MODEL OF SEVERE HAEMORRHAGIC SHOCK(2013) MALBOUISSON, L. M.; IDA, K. K.; OTSUKI, D. A.; CASTRO, L. U.; SANCHES, T. R.; SHIMIZU, M. M.; ANDRADE, L. C.; CARMONA, M. C.conferenceObject EFFECTS OF NITRIC OXIDE DONOR (NITROPRUSSIDE) AND INDUCIBLE NITRIC OXIDE SYNTHASE ENZYME INHIBITOR IN AN EXPERIMENTAL MODEL OF SEPTIC SHOCK(2013) FANTONI, D. T.; MONTEIRO, A.; OTSUKI, D. A.; CARNICELLI, P.; KAHVEGIAN, M.; AULER, J. C.article 8 Citação(ões) na Scopus Modulation of inflammation during acute normovolemic anemia with different fluid replacement(2013) KAHVEGIAN, M.; OTSUKI, D. Aya; HOLMS, C.; MASSOCO, C. Oliveira; AULER JUNIOR, J. O. Costa; FANTONI, D. TabacchiBackground. Acute normovolaemic anemia (ANA) frequently occurs during cardiopulmonary bypass (CPB) and major surgeries. We investigated whether fluids (with different compositions) used to replace blood elicit any degree of systemic or lung inflammatory response. Methods. We evaluated systemic and pulmonary inflammatory responses in a swine model of acute normovolemic anemia induced by 6% hydroxyethyl starch 130/0.4 (HES, N.=7), 0.9% saline solution (SS, N.=7), and gelatine (GEL, N.=7). Cytokine levels and neutrophil oxidative burst were analysed in the blood at baseline, 0, 60, and 120 min after hemodilution (TBL, TA, T60A, and T120A, respectively) as well as 60 (T60BI) and 120 mm (T120BI) after autologous blood reinfusion. Lung histology and expression of cyclooxygenase-2 (COX-2) and E-selectin were analysed at T120BI. Results. TNF-alpha, IL-6, and IL-10 levels at T60A were significantly higher in the GEL (P<0.05) and SS (P<0.05) groups than in the Control group. IL-1 beta was increased significantly in the GEL group (P<0.05) at T60H. Stimulated neutrophil oxidative burst in the blood was increased significantly only in the GEL group at TA (P<0.05). The GEL group presented higher COX-2 and E-selectin expression, followed by the saline and starch groups. The presence of inflammatory cell infiltration, oedema, congestion, and alveoli collapse was increased in the SS and GEL groups. Conclusion. In this animal model of acute normovolemic hemodilution, fluid solutions of hydroxyethyl starch, normal saline, and modified fluid gelatine were shown to be effective in replacing blood during ANA. However, compared to HES, GEL and NS elicited a more intense systemic and lung inflammatory response.conferenceObject STUDY OF THE EFFECTS OF METOPROLOL THERAPY IN EXPERIMENTAL SEPTIC SHOCK(2013) CORREA, A. L.; FANTONI, D. T.; AULER, J. O.; OTSUKI, D. A.