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
6 resultados
Resultados de Busca
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conferenceObject Comparison of respiratory muscle recruitments between maximal voluntary contraction and strenuous exercise(2013) SANTANA, Pauliane; CARDENAS, Leticia; PLETSCH, Renata; FERREIRA, Jeferson; ORLANDIM, Luiz; ANDRE, Albuquerque; CARLOS, Carvalho; TREVIZAN, Patricia; MALONI, Renan; CARUSO, Pedro- Interobserver agreement rate of the spontaneous breathing trial(2013) CAPPATI, Karina Reis Kappaz; TONELLA, Rodrigo Marques; DAMASCENA, Aline Santos; PEREIRA, Carlos Alberto de Braganca; CARUSO, PedroPurpose: During the mechanical ventilation weaning process, the spontaneous breathing trial (SBT) is the confirmatory test of patients' capability to breathe unassisted. However, the SBT interobserver agreement rate (its reliability) is unknown, and our objective was to evaluate it. Materials and Methods: This is a prospective, multicentric and observational study. Patients were included when the SBT criteria were fulfilled. Two physicians and 2 respiratory therapists (RTs) rated each SBT. The SBT interobserver agreement was measured using kappa statistic and also the percentage of agreement with its 95% credible interval (CrI) calculated by a Bayesian inference. Results: Ninety-three distinct physicians and 91 distinct RTs rated 130 SBTs. The kappa coefficient was 0.46 for physicians and 0.57 for RT, indicating a moderate interobserver agreement rate. The percentage of agreement was 87.7% between physicians (95% CrI, 81.0%-92.3%) and 86.2% between RT (95% CrI, 79.2%-91.1%). The physicians' and RT' percentage of agreement were not statistically different (P = .71). Conclusions: The SBT interobserver agreement rate is only moderate for physicians and RT. The percentage of agreement between 2 different SBT observers is 79.2% to 92.3%. Therefore, a relevant percentage of patients will have different extubation decisions depending on the SBT observer.
conferenceObject Ribcage and abdomen synchrony at different exercise intensities in healthy subjects(2013) CARDENAS, Leticia Z.; FERREIRA, Jeferson G.; SANTANA, Pauliana V.; PLETSCH, Renata; ORLANDIN, Luiz F.; MACCHIONE, Marcelo; CARUSO, Pedro; CARVALHO, Carlos R. R.; ALBUQUERQUE, Andre L. P.- Effect of intraoperative HES 6% 130/0.4 on the need for blood transfusion after major oncologic surgery: a propensity-matched analysis(2013) ZAMPIERI, Fernando Godinho; RANZANI, Otavio T.; MORATO, Priscila Fernanda; CAMPOS, Pedro Paulo; CARUSO, PedroOBJECTIVES: To evaluate the effect of the intraoperative use of hydroxyethyl starch on the need for blood products in the perioperative period of oncologic surgery. The secondary end-points included the need for other blood products, the clotting profile, the intensive care unit mortality and length of stay. METHODS: Retrospective observational analysis in a tertiary oncologic ICU in Brazil including 894 patients submitted to oncologic surgery for a two-year period from September 2007. Patients were grouped according to whether hydroxyethyl starch was used during surgery (hydroxyethyl starch and No-hydroxyethyl starch groups) and compared using a propensity score analysis. A total of 385 propensity-matched patients remained in the analysis (97 in the No-hydroxyethyl starch group and 288 in the hydroxyethyl starch group). RESULTS: A higher percentage of patients in the hydroxyethyl starch group required red blood cell transfusion during surgery (26% vs. 14%; p = 0.016) and in the first 24 hours after surgery (5% vs. 0%; p = 0.015) but not in the 24-to 48-hour period after the procedure. There was no difference regarding the transfusion of other blood products, intensive care unit mortality or length of stay. CONCLUSION: Hydroxyethyl starch use in the intraoperative period of major oncologic surgery is associated with an increase in red blood cell transfusions. There are no differences in the need for other blood products, intensive care unit length of stay or mortality.
conferenceObject Dynamic recruitment and maximal force of respiratory muscles in healthy subjects undergone strenuous exercise(2013) PLETSCH, Renata; ALBUQUERQUE, Andre; CARUSO, Pedro; CARDENAS, Leticia; SANTANA, Pauliane Vieira; MALONI, Renan; APANAVICIUS, Andre; FERREIRA, Jeferson George; SALGE, Joao Marcos; CARVALHO, Carlos Roberto Ribeiro De- Very Early Passive Cycling Exercise in Mechanically Ventilated Critically Ill Patients: Physiological and Safety Aspects - A Case Series(2013) PIRES-NETO, Ruy Camargo; KAWAGUCHI, Yurika Maria Fogaca; HIROTA, Adriana Sayuri; FU, Carolina; TANAKA, Clarice; CARUSO, Pedro; PARK, Marcelo; CARVALHO, Carlos Roberto RibeiroIntroduction: Early mobilization can be performed in critically ill patients and improves outcomes. A daily cycling exercise started from day 5 after ICU admission is feasible and can enhance functional capacity after hospital discharge. In the present study we verified the physiological changes and safety of an earlier cycling intervention (<< 72 hrs of mechanical ventilation) in critical ill patients. Methods: Nineteen hemodynamically stable and deeply sedated patients within the first 72 hrs of mechanical ventilation were enrolled in a single 20 minute passive leg cycling exercise using an electric cycle ergometer. A minute-by-minute evaluation of hemodynamic, respiratory and metabolic variables was undertaken before, during and after the exercise. Analyzed variables included the following: cardiac output, systemic vascular resistance, central venous blood oxygen saturation, respiratory rate and tidal volume, oxygen consumption, carbon dioxide production and blood lactate levels. Results: We enrolled 19 patients (42% male, age 55 +/- 17 years, SOFA = 6 +/- 3, SAPS3 score = 58 +/- 13, PaO2/FIO2 = 223 +/- 75). The median time of mechanical ventilation was 1 day (02), and 68% (n=13) of our patients required norepinephrine (maximum concentration = 0.47 mu g. kg(-1). min(-1)). There were no clinically relevant changes in any of the analyzed variables during the exercise, and two minor adverse events unrelated to hemodynamic instability were observed. Conclusions: In our study, this very early passive cycling exercise in sedated, critically ill, mechanically ventilated patients was considered safe and was not associated with significant alterations in hemodynamic, respiratory or metabolic variables even in those requiring vasoactive agents.