PEDRO CARUSO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
97 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 97
- ICU Architectural Design Affects the Delirium Prevalence: A Comparison Between Single-Bed and Multibed Rooms(2014) CARUSO, Pedro; GUARDIAN, Lilian; TIENGO, Tatiane; SANTOS, Lucio Souza dos; MEDEIROS JUNIOR, PedroObjectives: Delirium risk factors are related to the patients' acute and chronic clinical condition, treatment, and environment. The environmental risk factors are essentially determined by the ICU architectural design. Although there are countless architectural variations among the ICUs, all can be classified as single-or multibed rooms. Our objectives were to compare the ICU delirium prevalence and characteristics (coma/delirium-free days, first day in delirium, and delirium motoric subtypes) of critically ill patients admitted in single-or multibed rooms. Design: Retrospective. Setting: ICU of a teaching oncologic hospital with 31 beds. Twenty-three beds distributed in one multibed room with 13 beds and other with 10 beds. Eight beds distributed in single-bed rooms. Patients: All adult patients admitted from February to November 2011. Interventions: None. Measurements and Main Results: We evaluated 1,587 patients and included 1,253 patients. Patients' characteristics at ICU admission and their outcomes along the ICU stay were not different between patients admitted in single-or multibed rooms. One hundred sixty-three patients (13.0%) had delirium, and the prevalence was significantly lower in patients admitted in single-bed rooms (6.8% x 15.1%; p < 0.01). This lower prevalence occurred in patients admitted due to a medical (11.0% x 25.6%; p < 0.01) or postoperative (5.0% x 11.4%; p < 0.01) reason. However, the coma/ delirium-free days, the first day in delirium, and the delirium motoric subtypes were not different between the single-and multibed rooms. The risk factors associated with delirium were admission in multibed rooms (odds ratio, 4.03; 95% CI, 2.13-7.62), older age, ICU-acquired infection, and higher Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment score. Conclusions: Critically ill patients admitted in single-bed rooms have a lower prevalence of delirium than those admitted in multibed rooms. However, coma/delirium-free days, first day in delirium, and motoric subtypes were not different.
- Diaphragmatic dysfunction evaluated by ultrasound correlates with dyspnea, exercise and quality of life in interstitial lung disease(2016) SANTANA, Pauliane; CARDENAS, Leticia; FERREIRA, Jeferson; IAMONTI, Vinicius; RAMOS, Ozires; JAEGER, Thomas; ALBUQUERQUE, Andre; CARVALHO, Carlos; CARUSO, Pedro
bookPart Treinamento dos músculos respiratórios(2016) CARUSO, Pedro- Outcomes and prognostic factors of decompensated pulmonary hypertension in the intensive care unit(2021) GARCIA, Marcos Vinicius Fernandes; SOUZA, Rogerio; COSTA, Eduardo Leite Vieira; FERNANDES, Caio Julio Cesar Santos; JARDIM, Carlos Viana Poyares; CARUSO, PedroBackground: Patients with acute decompensation of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) admitted to intensive care unit (ICU) have high in-hospital mortality. We hypothesized that pulmonary hypertension (PH) severity, measured by a simplified version of European Society of Cardiology/European Respiratory Society (ESC/ERS) risk assessment, and the severity of organ dysfunction upon ICU admission, measured by sequential organ failure assessment score (SOFA) were associated with in-hospital mortality in decompensated patients with PAH and CTEPH. We also described clinical and laboratory variables during ICU stay. Methods: Observational study including adults with decompensated PAH or CTEPH with unplanned ICU admission between 2014 and 2019. Multivariate logistic regression models were used to evaluate the association of ESC/ERS risk assessment and SOFA score with in-hospital mortality. ESC/ERS risk assessment and SOFA score were included in a decision tree to predict in-hospital mortality. Results: 73 patients were included. In-hospital mortality was 41.1%. ESC/ERS high-risk group (adjusted odds ratio = 95.52) and SOFA score (adjusted odds ratio = 1.80) were associated with in-hospital mortality. The decision tree identified four groups with in-hospital mortality between 8.1% and 100%. Nonsurvivors had a lower central venous oxygen saturation, higher arterial lactate and higher brain natriuretic peptide in the end of first week in the ICU. Conclusions: High-risk on a simplified version of ERS/ESC risk assessment and SOFA score upon ICU admission are associate with in-hospital mortality. A decision tree based on ESC/ERS risk assessment and SOFA score identifies four groups with in-hospital mortality between 8.1% and 100%.
- Carga de trabalho da enfermagem associada com frequência de visitas multidisciplinares: um estudo transversal(2021) BORGES, Maria Luiza; CARUSO, Pedro; NASSAR JÚNIOR, Antonio PauloAbstract Objective: To assess the frequency of multidisciplinary rounds during ICU days, to evaluate the participation of diverse healthcare professionals, to identify the reasons why rounds were not performed on specific days, and whether bed occupancy rate and nurse workload were associated with the conduction of multidisciplinary rounds. Methods: We performed a cross-sectional study to assess the frequency of multidisciplinary rounds in four intensive care units in a cancer center. We also collected data on rates of professional participation, reasons for not performing rounds when they did not occur, and daily bed occupancy rates and assessed nurse workload by measuring the Nursing Activity Score. Results: Rounds were conducted on 595 (65.8%) of 889 surveyed intensive care unit days. Nurses, physicians, respiratory therapists, pharmacists, and infection control practitioners participated most often. Rounds did not occur due to admission of new patients at the scheduled time (136; 44.7%) and involvement of nurses in activities unrelated to patients’ care (97; 31.9%). In multivariate analysis, higher Nursing Activity Scores were associated with greater odds of conducting multidisciplinary rounds (OR = 1.06; 95%CI 1.04 - 1.10; p < 0.01), whereas bed occupancy rates were not (OR = 0.99; 95%CI 0.97 - 1.00; p = 0.18). Conclusion: Multidisciplinary rounds were conducted on less than two-thirds of surveyed intensive care unit days. Many rounds were cancelled due to activities unrelated to patient care. Unexpectedly, increased workload was associated with higher odds of conducting rounds. Workload is a possible trigger to discuss daily goals to improve patient outcomes and to enhance the effectiveness of multidisciplinary teams.
conferenceObject Diaphragmatic dysfunction in interstitial lung disease: An ultrasonography study(2014) SANTANA, Pauliane Vieira; PRINA, Elena; PLETSCH, Renata; FERREIRA, Jeferson; PEREIRA, Mayra Caleff; US, Andre Apanav; TREVISAN, Patricia; ALBUQUERQUE, Andre P.; CARVALHO, Carlos Roberto R.; CARUSO, Pedro- Single-Bed or Multibed Room Designs Influence ICU Staff Stress and Family Satisfaction, But Do Not Influence ICU Staff Burnout(2020) MATOS, Liane Brescovici Nunes de; FUMIS, Renata Rego Lins; NASSAR JUNIOR, Antonio Paulo; LACERDA, Fabio Holanda; CARUSO, PedroObjective: To compare the impact of single-bed versus multibed room intensive care units (ICU) architectural designs on the stress and burnout of ICU staff and on the stress and satisfaction of family visitors. Background: There are countless architectural variations among ICUs, but all involve single-bed or multibed rooms. Although it is well known that ICU design affects important patient outcomes, the effect of ICU design on family and staff has been insufficiently studied. Methods: Among ICU staff and family visitors, stress was evaluated with Lipp's Inventory of Stress Symptoms. ICU staff burnout was evaluated with the Maslach Burnout Inventory. Family visitor satisfaction was evaluated with Molter's Critical Care Family Needs Inventory. Results: Among 156 ICU professionals who were interviewed, similar burnout rates were observed between ICU staff who worked single-bed versus multibed rooms. However, stress reported by ICU staff within the previous 24 hr was higher among the ICU staff who worked in single-bed rooms (14.3% vs. 4.7%, p = .04). Among 176 family visitors who were interviewed, a similar level of stress was reported by family members who visited patients in single-bed or multibed rooms. However, the satisfaction of family members visiting patients in single-bed rooms was higher (96.0% vs. 84.6%, p = .02). Conclusions: Single-bed ICU design was associated with greater satisfaction of family visitors yet with higher levels of stress for ICU staff. Meanwhile, similar burnout levels were observed for ICU staff who worked in single-bed or multibed rooms.
- Ischemia/reperfusion-induced lung injury prevention: many options, no choices(2016) CARUSO, Pedro; GOMES, Susimeire
- Regional ventilation of patients with hemidiaphragm paralysis by electrical impedance tomography(2015) PEREIRA, Mayra Caleffi; TORSANI, Vinicius; APANAVICIUS, Andre; FERREIRA, Jeferson George; IAMONTI, Vinicius C.; AMATO, Marcelo Britto Passos; CARVALHO, Carlos Roberto Ribeiro de; ALBUQUERQUE, Andre Luis Pereira de; CARUSO, Pedro
conferenceObject Echocardiographic Predictors of Mortality in Acute Decompensated Pulmonary Hypertension in the ICU(2019) MACEDO, B. R.; GARCIA, M.; SOUZA, R.; CARUSO, P.