CARLOS ROBERTO RIBEIRO DE CARVALHO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina - Líder
306 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 306
- 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
- Plano de análise estatística para o Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART). Ensaio controlado randomizado(2017) DAMIANI, Lucas Petri; BERWANGER, Otavio; PAISANI, Denise; LARANJEIRA, Ligia Nasi; SUZUMURA, Erica Aranha; AMATO, Marcelo Britto Passos; CARVALHO, Carlos Roberto Ribeiro; CAVALCANTI, Alexandre BiasiABSTRACT Background: The Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) is an international multicenter randomized pragmatic controlled trial with allocation concealment involving 120 intensive care units in Brazil, Argentina, Colombia, Italy, Poland, Portugal, Malaysia, Spain, and Uruguay. The primary objective of ART is to determine whether maximum stepwise alveolar recruitment associated with PEEP titration, adjusted according to the static compliance of the respiratory system (ART strategy), is able to increase 28-day survival in patients with acute respiratory distress syndrome compared to conventional treatment (ARDSNet strategy). Objective: To describe the data management process and statistical analysis plan. Methods: The statistical analysis plan was designed by the trial executive committee and reviewed and approved by the trial steering committee. We provide an overview of the trial design with a special focus on describing the primary (28-day survival) and secondary outcomes. We describe our data management process, data monitoring committee, interim analyses, and sample size calculation. We describe our planned statistical analyses for primary and secondary outcomes as well as pre-specified subgroup analyses. We also provide details for presenting results, including mock tables for baseline characteristics, adherence to the protocol and effect on clinical outcomes. Conclusion: According to best trial practice, we report our statistical analysis plan and data management plan prior to locking the database and beginning analyses. We anticipate that this document will prevent analysis bias and enhance the utility of the reported results. Trial registration: ClinicalTrials.gov number, NCT01374022.
conferenceObject Evaluation Of The Functional Impact Of The Use Of Doxycycline For Three Years In Patients With Lymphangioleiomyomatosis(2014) BALDI, B. G.; PIMENTA, S. P.; ARAUJO, M. S.; FREITAS, C. S. G.; KAIRALLA, R. A.; CARVALHO, C. R. R.- Computed tomography in hypersensitivity pneumonitis: main findings, differential diagnosis and pitfalls(2018) DIAS, Olivia Meira; BALDI, Bruno Guedes; PENNATI, Francesca; ALIVERTI, Andrea; CHATE, Rodrigo Caruso; SAWAMURA, Marcio Valente Yamada; CARVALHO, Carlos Roberto Ribeiro de; ALBUQUERQUE, Andre Luis Pereira deIntroduction: Hypersensitivity pneumonitis (HP) is a disease with variable clinical presentation in which inflammation in the lung parenchyma is caused by the inhalation of specific organic antigens or low molecular weight substances in genetically susceptible individuals. Alterations of the acute, subacute and chronic forms may eventually overlap, and the diagnosis based on temporality and presence of fibrosis (acute/inflammatory HP vs. chronic HP) seems to be more feasible and useful in clinical practice. Differential diagnosis of chronic HP with other interstitial fibrotic diseases is challenging due to the overlap of the clinical history, and the functional and imaging findings of these pathologies in the terminal stages.Areas covered: This article reviews the essential features of HP with emphasis on imaging features. Moreover, the main methodological limitations of high-resolution computed tomography (HRCT) interpretation are discussed, as well as new perspectives with volumetric quantitative CT analysis as a useful tool for retrieving detailed and accurate information from the lung parenchyma.Expert commentary: Mosaic attenuation is a prominent feature of this disease, but air trapping in chronic HP seems overestimated. Quantitative analysis has the potential to estimate the involvement of the pulmonary parenchyma more accurately and could correlate better with pulmonary function results.
- Adenopathy and Pulmonary Infiltrates in a Japanese Emigrant in Brazil(2011) KAWASSAKI, Alexandre M.; HAGA, Hironori; DANTAS, Thiago C. A.; MUSOLINO, Rafael S.; BALDI, Bruno G.; CARVALHO, Carlos R. R.; KAIRALLA, Ronaldo A.; MAUAD, Thais
- Lung ultrasound in the evaluation of pleural effusion(2014) PRINA, Elena; TORRES, Antoni; CARVALHO, Carlos Roberto Ribeiro
bookPart DPOC exacerbada(2018) RACHED, Samia Zahi; ALMEIDA, Guilherme Eler de; CARVALHO, Carlos Roberto Ribeiro de- Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial(2013) ORNICO, Susana R.; LOBO, Suzana M.; SANCHES, Helder S.; DEBERALDINI, Maristela; TOFOLI, Luciane T.; VIDAL, Ana M.; SCHETTINO, Guilherme P.; AMATO, Marcelo B.; CARVALHO, Carlos R.; BARBAS, Carmen S.Introduction: Noninvasive ventilation (NIV), as a weaning-facilitating strategy in predominantly chronic obstructive pulmonary disease (COPD) mechanically ventilated patients, is associated with reduced ventilator-associated pneumonia, total duration of mechanical ventilation, length of intensive care unit (ICU) and hospital stay, and mortality. However, this benefit after planned extubation in patients with acute respiratory failure of various etiologies remains to be elucidated. The aim of this study was to determine the efficacy of NIV applied immediately after planned extubation in contrast to oxygen mask (OM) in patients with acute respiratory failure (ARF). Methods: A randomized, prospective, controlled, unblinded clinical study in a single center of a 24-bed adult general ICU in a university hospital was carried out in a 12-month period. Included patients met extubation criteria with at least 72 hours of mechanical ventilation due to acute respiratory failure, after following the ICU weaning protocol. Patients were randomized immediately before elective extubation, being randomly allocated to one of the study groups: NIV or OM. We compared both groups regarding gas exchange 15 minutes, 2 hours, and 24 hours after extubation, reintubation rate after 48 hours, duration of mechanical ventilation, ICU length of stay, and hospital mortality. Results: Forty patients were randomized to receive NIV (20 patients) or OM (20 patients) after the following extubation criteria were met: pressure support (PSV) of 7 cm H2O, positive end-expiratory pressure (PEEP) of 5 cm H2O, oxygen inspiratory fraction (FiO(2)) <= 40%, arterial oxygen saturation (SaO(2)) >= 90%, and ratio of respiratory rate and tidal volume in liters (f/TV) < 105. Comparing the 20 patients (NIV) with the 18 patients (OM) that finished the study 48 hours after extubation, the rate of reintubation in NIV group was 5% and 39% in OM group (P = 0.016). Relative risk for reintubation was 0.13 (CI = 0.017 to 0.946). Absolute risk reduction for reintubation showed a decrease of 33.9%, and analysis of the number needed to treat was three. No difference was found in the length of ICU stay (P = 0.681). Hospital mortality was zero in NIV group and 22.2% in OM group (P = 0.041). Conclusions: In this study population, NIV prevented 48 hours reintubation if applied immediately after elective extubation in patients with more than 3 days of ARF when compared with the OM group.
- Short-term effects of stored homologous red blood cell transfusion on cardiorespiratory function and inflammation: an experimental study in a hypovolemia model(2018) BIAGINI, S.; DALE, C. S.; REAL, J. M.; MOREIRA, E. S.; CARVALHO, C. R. R.; SCHETTINO, G. P. P.; WENDEL, S.; AZEVEDO, L. C. P.The pathophysiological mechanisms associated with the effects of red blood cell (RBC) transfusion on cardiopulmonary function and inflammation are unclear. We developed an experimental model of homologous 14-days stored RBC transfusion in hypovolemic swine to evaluate the short-term effects of transfusion on cardiopulmonary system and inflammation. Sixteen healthy male anesthetized swine (68 +/- 3.3 kg) were submitted to controlled hemorrhage (25% of blood volume). Two units of non-filtered RBC from each animal were stored under blood bank conditions for 14 days. After 30 min of hypovolemia, the control group (n=8) received an infusion of lactated Ringer's solution (three times the removed volume). The transfusion group (n=8) received two units of homologous 14-days stored RBC and lactated Ringer's solution in a volume that was three times the difference between blood removed and blood transfusion infused. Both groups were followed up for 6 h after resuscitation with collection of hemodynamic and respiratory data. Cytokines and RNA expression were measured in plasma and lung tissue. Stored RBC transfusion significantly increased mixed oxygen venous saturation and arterial oxygen content. Transfusion was not associated with alterations on pulmonary function. Pulmonary concentrations of cytokines were not different between groups. Gene expression for lung cytokines demonstrated a 2-fold increase in mRNA level for inducible nitric oxide synthase and a 0.5-fold decrease in mRNA content for IL-21 in the transfused group. Thus, stored homologous RBC transfusion in a hypovolemia model improved cardiovascular parameters but did not induce significant effects on microcirculation, pulmonary inflammation and respiratory function up to 6 h after transfusion.
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