AUGUSTO SCALABRINI NETO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
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bookPart Introdução à sexta edição(2020) OLIVEIRA, Andréa Remigio de; MENDES, Pedro Vitale; PARK, Marcelo; ZIGAIB, Rogério; SCALABRINI NETO, Augusto; VELASCO, Irineu TadeubookPart Manejo das arritmias cardíacas(2023) DIAS, Roger Daglius; GIUGNI, Fernando Rabioglio; SCALABRINI NETO, Augusto- Acute stress in residents during emergency care: a study of personal and situational factors(2017) DIAS, Roger Daglius; SCALABRINI NETO, AugustoProviding care for simulated emergency patients may induce considerable acute stress in physicians. However, the acute stress provoked in a real-life emergency room (ER) is not well known. Our aim was to assess acute stress responses in residents during real emergency care and investigate the related personal and situational factors. A cross-sectional observational study was carried out at an emergency department of a tertiary teaching hospital. All second-year internal medicine residents were invited to voluntarily participate in this study. Acute stress markers were assessed at baseline (T1), before residents started their ER shift, and immediately after an emergency situation (T2), using heart rate, systolic, and diastolic blood pressure, salivary -amylase activity, salivary interleukin-1 , and the State-Trait Anxiety Inventory (STAI-s and STAI-t). Twenty-four residents were assessed during 40 emergency situations. All stress markers presented a statistically significant increase between T1 and T2. IL-1 presented the highest percent increase (141.0%, p<.001), followed by AA (99.0%, p=.002), HR (81.0%, p<.001), DBP (8.0%, p<.001), and SBP (3.0%, p<.001). In the multivariable analysis, time of residency had a negative correlation with HR during the emergency (adjusted R-square=.168; F=8.69; p=.006), SBP response (adjusted R-square=.210; F=6.19; p=.005) and DBP response (adjusted R-square=.293; F=9.09; p=.001). Trait anxiety (STAI-t) was positively correlated with STAI-s (adjusted R-square=.326; F=19.9; p<.001), and number of procedures performed during emergency care had a positive association with HR response (adjusted R-square=.241; F=5.02; p=.005). In the present study, emergency care provoked substantial acute stress in residents. Resident experience, trait anxiety, and number of emergency procedures were independently associated with acute stress response.
bookPart Insuficiência Cardíaca Crônica(2015) SCALABRINI NETO, Augusto; MAZON, Francisco José Nigro; DIAS, Roger DagliusbookPart Treinamento de habilidades na prática médica(2023) DIAS, Roger Daglius; RODRIGUES, Katharina Reichmann; SCALABRINI NETO, AugustobookPart Apresentação(2023) SCALABRINI NETO, Augusto; DIAS, Roger Daglius- A Randomized Trial of Noninvasive Positive End Expiratory Pressure in Patients With Acquired Immune Deficiency Syndrome and Hypoxemic Respiratory Failure(2012) ANJOS, Carlos Frederico Dantas; SCHETTINO, Guilherme Paula Pinto; PARK, Marcelo; SOUZA, Vladimir Silva; SCALABRINI NETO, AugustoBACKGROUND: Acquired immunodeficiency syndrome (AIDS) is a pandemic disease commonly associated with respiratory infections, hypoxemia, and death. Noninvasive PEEP has been shown to improve hypoxemia. In this study, we evaluated the physiologic effects of different levels of noninvasive PEEP in hypoxemic AIDS patients. METHODS: Thirty AIDS patients with acute hypoxemic respiratory failure received a randomized sequence of noninvasive PEEP (5, 10, or 15 cm H2O) for 20 min. PEEP was provided through a facial mask with pressure-support ventilation (PSV) of 5 cm H2O and an F-IO2, of 1. Patients were allowed to breathe spontaneously for a 20-min washout period in between each PEEP trial. Arterial blood gases and clinical variables were recorded after each PEEP treatment. RESULTS: The results indicate that oxygenation improves linearly with increasing levels of PEEP. However, oxygenation levels were similar regardless of the first PEEP level administered (5, 10, or 15 cm H2O), and only the subgroup that received an initial treatment of the lowest level of PEEP (ie, 5 cm H2O) showed further improvements in oxygenation when higher PEEP levels were subsequently applied. The P-aCO2, also increased in response to PEEP elevation, especially with the highest level of PEEP (ie, 15 cm H2O). PSV of 5 cm H2O use was associated with significant and consistent improvements in the subjective sensations of dyspnea and respiratory rate reported by patients treated with any level of PEEP (from 0 to 15 cm H2O). CONCLUSIONS: AIDS patients with hypoxemic respiratory failure improve oxygenation in response to a progressive sequential elevation of PEEP (up to 15 cm H2O). However, corresponding elevations in P-aCO2, limit the recommended level of PEEP to 10 cm H2O. At a level of 5 cm H2O, PSV promotes an improvement in the subjective sensation of dyspnea regardless of the PEEP level employed.
book Emergências clínicas: abordagem prática [7.ed. rev. ampl.](2012) MARTINS, Herlon Saraiva; BRANDãO NETO, Rodrigo Antonio; SCALABRINI NETO, Augusto; VELASCO, Irineu TadeubookPart Hipertensão Arterial Sistêmica(2015) SCALABRINI NETO, Augusto; MAZON, Francisco José Nigro; DIAS, Roger Daglius- Use of CentriMag for refractory cardiogenic shock in a puerperal woman: case report(2021) PEGO-FERNANDES, Paulo Manuel; SCALABRINI NETO, Augusto; HAJJAR, Ludhmila Abrahao; COSTA, Priscila Berenice da; FILHO, Roberto Kalil; JATENE, Fabio BiscegliCONTEXT: Heart failure in Brazil is a major public health problem and, even with advances in treatment, it still presents high morbidity and mortality. As a treatment option, mechanical circulatory assist devices (MCADs) have greatly increased in importance over the last decade. CASE REPORT: This report concerns a case of refractory cardiogenic shock due to acute myocarditis in a 35-year-old puerperal female patient who presented with retrosternal pain, fatigue and dyspnea. At the hospital, she was diagnosed with myocarditis. There was no improvement in perfusion even after receiving dobutamine, intra-aortic balloon passage (IAB) and venoarterial extracorporeal membrane oxygenation (VA-ECMO). Therefore, it was decided to implant a MCAD (CentriMag). During hospitalization, recovery from the bi-ventricular dysfunction was achieved. The CentriMag device was removed 10 days after it had been implanted, and the patient was discharged after another 8 days. The myocarditis was proven to be due to the Coxsackie virus. CONCLUSIONS: The decision to implant a MCAD should be individualized, as patient profiles do not always match the indications in the guidelines and protocols. In this study, clinical discussion of the case among the medical and multi-professional teams was essential in order to be able to successfully reverse the patient's severe clinical condition without sequelae, through using a CentriMag implant.