ROBERTA RIBEIRO DE SANTIS SANTIAGO
Projetos de Pesquisa
Unidades Organizacionais
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
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Agora exibindo 1 - 10 de 10
conferenceObject Peep Titration In Severe Acute Respiratory Distress Syndrome: Different Physiological Consequences When Guided By Electrical Impedance Tomography Versus Esophageal Pressure(2017) ROLDAN, R.; LIMA, C.; YOSHIDA, T.; SANTIAGO, R. R. D. S.; GOMES, S.; TUCCI, M. R.; BERALDO, M. A.; COSTA, E. L. V.; TORSANI, V.; NAKAMURA, M. A. M.; CARVALHO, C. R. R.; AMATO, M. B. P.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.conferenceObject Idiopathic Pulmonary Arterial Hypertension Leading To Dynamic Bronchial Compression And Orthopnea: A Case Report Of The Use Of Electrical Impedance Tomography (eit) As A New Investigation Tool In Pulmonary Function Test(2015) ARIMURA, F. E.; SANTIAGO, R. R. S. S.; GAVILANES, F.; ALVES, J. L.; JARDIM, C.; AMATO, M. B. P.; COSTA, E. L. V.; SALGE, J. M.; SOUZA, R.- The Recruitability Paradox(2016) AMATO, Marcelo B. P.; SANTIAGO, Roberta R. De Santis
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 Spontaneous Breathing During Mechanical Ventilation Causes Unsuspected Over-Inflation Of Dependent Lung(2013) YOSHIDA, T.; TORSANI, V.; GOMES, S.; SANTIAGO, R. R. S.; CARVALHO, C. R. R.; KAVANAGH, B. P.; AMATO, M. B. P.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- Volume-controlled Ventilation Does Not Prevent Injurious Inflation during Spontaneous Effort(2017) YOSHIDA, Takeshi; NAKAHASHI, Susumu; NAKAMURA, Maria Aparecida Miyuki; KOYAMA, Yukiko; ROLDAN, Rollin; TORSANI, Vinicius; SANTIS, Roberta R. De; GOMES, Susimeire; UCHIYAMA, Akinori; AMATO, Marcelo B. P.; KAVANAGH, Brian P.; FUJINO, YujiRationale: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and VT, and worsens lung injury. Intuitively, controlling VT and transpulmonary pressure might limit injury caused by added spontaneous effort. Objectives: To test the hypothesis that, during spontaneous effort in injured lungs, limitation of VT and transpulmonary pressure by volume-controlled ventilation results in less injurious patterns of inflation. Methods: Dynamic computed tomography was used to determine patterns of regional inflation in rabbits with injured lungs during volume-controlled or pressure-controlled ventilation. Transpulmonary pressure was estimated by using esophageal balloon manometry [PL(es)] with and without spontaneous effort. Local dependent lung stress was estimated as the swing (inspiratory change) in transpulmonary pressure measured by intrapleural manometry in dependent lung and was compared with the swing in PL(es). Electrical impedance tomography was performed to evaluate the inflation pattern in a larger animal (pig) and in a patient with acute respiratory distress syndrome. Measurements and Main Results: Spontaneous breathing in injured lungs increased PL(es) during pressure-controlled (but not volume-controlled) ventilation, but the pattern of dependent lung inflation was the same in both modes. In volume-controlled ventilation, spontaneous effort caused greater inflation and tidal recruitment of dorsal regions (greater than twofold) compared with during muscle paralysis, despite the same VT and PL(es). This was caused by higher local dependent lung stress (measured by intrapleural manometry). In injured lungs, esophageal manometry underestimated local dependent pleural pressure changes during spontaneous effort. Conclusions: Limitation of VT and PL(es) by volume-controlled ventilation could not eliminate harm caused by spontaneous breathing unless the level of spontaneous effort was lowered and local dependent lung stress was reduced.
- Spontaneous Effort Causes Occult Pendelluft during Mechanical Ventilation(2013) YOSHIDA, Takeshi; TORSANI, Vinicius; GOMES, Susimeire; SANTIS, Roberta R. De; BERALDO, Marcelo A.; COSTA, Eduardo L. V.; TUCCI, Mauro R.; ZIN, Walter A.; KAVANAGH, Brian P.; AMATO, Marcelo B. P.Rationale: In normal lungs, local changes in pleural pressure (P-pl) are generalized over the whole pleural surface. However, in a patient with injured lungs, we observed (using electrical impedance tomography) a pendelluft phenomenon (movement of air within the lung from nondependent to dependent regions without change in tidal volume) that was caused by spontaneous breathing during mechanical ventilation. Objectives: To test the hypotheses that in injured lungs negative P-pl generated by diaphragm contraction has localized effects (in dependent regions) that are not uniformly transmitted, and that such localized changes in P-pl cause pendelluft. Methods: We used electrical impedance tomography and dynamic computed tomography (CT) to analyze regional inflation in anesthetized pigs with lung injury. Changes in local P-pl were measured in nondependent versus dependent regions using intrabronchial balloon catheters. The airway pressure needed to achieve comparable dependent lung inflation during paralysis versus spontaneous breathing was estimated. Measurements and Main Results: In all animals, spontaneous breathing caused pendelluft during early inflation, which was associated with more negative local P-pl in dependent regions versus nondependent regions (-13.0 +/- 4.0 vs. -6.4 +/- 3.8 cm H2O; P < 0.05). Dynamic CT confirmed pendelluft, which occurred despite limitation of tidal volume to less than 6 ml/kg. Comparable inflation of dependent lung during paralysis required almost threefold greater driving pressure (and tidal volume) versus spontaneous breathing (28.0 +/- 0.5 vs. 10.3 +/- 0.6 cm H2O, P < 0.01; 14.8 +/- 4.6 vs. 5.8 +/- 1.6 ml/kg, P < 0.05). Conclusions: Spontaneous breathing effort during mechanical ventilation causes unsuspected overstretch of dependent lung during early inflation (associated with reciprocal deflation of nondependent lung). Even when not increasing tidal volume, strong spontaneous effort may potentially enhance lung damage.
conferenceObject Respiratory Mechanics Assessed By Forced Oscillations And Electrical Impedance Tomography(2015) CRUZ, A. F.; MORIYA, H. T.; GOMES, S.; SANTIAGO, R. R. S.; ORTIZ, T. A.; AMATO, M. B. P.; CARVALHO, C. R. R.