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
17 resultados
Resultados de Busca
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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, PedroconferenceObject An integrative and comprehensive approach to evaluate lung mechanics in seated and upright positions(2012) ALBUQUERQUE, Andre; CARUSO, Pedro; PLETSCH, Renata; SANTANA, Pauliane; CARDENAS, Leticia; APANAVICIUS, Andre; ROZIN, Gabriel; MACCHIONE, Marcelo; SALGE, Joao Marcos; CARVALHO, Carlos- Accuracy of Invasive and Noninvasive Parameters for Diagnosing Ventilatory Overassistance During Pressure Support Ventilation*(2018) PLETSCH-ASSUNCAO, Renata; PEREIRA, Mayra Caleffi; FERREIRA, Jeferson George; CARDENAS, Leticia Zumpano; ALBUQUERQUE, Andre Luis Pereira de; CARVALHO, Carlos Roberto Ribeiro de; CARUSO, PedroObjective: Evaluate the accuracy of criteria for diagnosing pressure overassistance during pressure support ventilation. Design: Prospective clinical study. Setting: Medical-surgical ICU. Patients: Adults under mechanical ventilation for 48 hours or more using pressure support ventilation and without any sedative for 6 hours or more. Overassistance was defined as the occurrence of work of breathing less than 0.3 J/L or 10% or more of ineffective inspiratory effort. Two alternative overassistance definitions were based on the occurrence of inspiratory esophageal pressure-time product of less than 50 cm H2O s/min or esophageal occlusion pressure of less than 1.5 cm H2O. Interventions: The pressure support was set to 20 cm H2O and decreased in 3-cm H2O steps down to 2 cm H2O. Measurements and Main Results: The following parameters were evaluated to diagnose overassistance: respiratory rate, tidal volume, minute ventilation, peripheral arterial oxygen saturation, rapid shallow breathing index, heart rate, mean arterial pressure, change in esophageal pressure during inspiration, and esophageal and airway occlusion pressure. In all definitions, the respiratory rate had the greatest accuracy for diagnosing overassistance (receiver operating characteristic area = 0.92; 0.91 and 0.76 for work of breathing, pressure-time product and esophageal occlusion pressure in definition, respectively) and always with a cutoff of 17 incursions per minute. In all definitions, a respiratory rate of less than or equal to 12 confirmed overassistance (100% specificity), whereas a respiratory rate of greater than or equal to 30 excluded overassistance (100% sensitivity). Conclusion: A respiratory rate of 17 breaths/min is the parameter with the greatest accuracy for diagnosing overassistance. Respiratory rates of less than or equal to 12 or greater than or equal to 30 are useful clinical references to confirm or exclude pressure support overassistance.
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- Lung function in seated and supine positions to predict diaphragm weakness in diaphragmatic paralysis(2017) PEREIRA, Mayra Caleffi; FERREIRA, Jeferson George; IAMONTI, Vinicius Carlos; CARDENAS, LetiCia; PLETSCH, Renata; SANTANA, Pauliane Vieira; CARVALHO, Carlos Roberto Ribeiro de; CARUSO, Pedro; ALBUQUERQUE, Andre Luis Pereira de; TREVIZAN, PatriCia
- Thoracoabdominal asynchrony: Two methods in healthy, COPD, and interstitial lung disease patients(2017) PEREIRA, Mayra Caleffi; PORRAS, Desiderio Cano; LUNARDI, Adriana Claudia; SILVA, Cibele Cristine Berto Marques da; BARBOSA, Renata Cleia Claudino; CARDENAS, Letivia Zumpano; PLETSCH, Renata; FERREIRA, Jeferson George; CASTRO, Isac de; CARVALHO, Celso Ricardo Fernandes de; CARUSO, Pedro; CARVALHO, Carlos Roberto Ribeiro de; ALBUQUERQUE, Andrea Luis Pereira deBackground Thoracoabdominal asynchrony is the nonparallel motion of the ribcage and abdomen. It is estimated by using respiratory inductive plethysmography and, recently, using optoelectronic plethysmography; however the agreement of measurements between these 2 techniques is unknown. Therefore, the present study compared respiratory inductive plethysmography with optoelectronic plethysmography for measuring thoracoabdominal asynchrony to see if the measurements were similar or different. Methods 27 individuals (9 healthy subjects, 9 patients with interstitial lung disease, and 9 with chronic obstructive pulmonary disease performed 2 cycle ergometer tests with respiratory inductive plethysmography or optoelectronic plethysmography in a random order. Thoracoabdominal asynchrony was evaluated at rest, and at 50% and 75% of maximal workload between the superior ribcage and abdomen using a phase angle. Results Thoracoabdominal asynchrony values were very similar in both approaches not only at rest but also with exercise, with no statistical difference. There was a good correlation between the methods and the Phase angle values were within the limits of agreement in the Bland-Altman analysis. Conclusion Thoracoabdominal asynchrony measured by optoelectronic plethysmography and respiratory inductive plethysmography results in similar values and has a satisfactory agreement at rest and even for different exercise intensities in these groups.
- Breathing Under Pressure: An exploratory analysis of differences in respiratory muscle activity and work of breathing during exercise in COPD and ILD(2023) FERREIRA, Jeferson George; IAMONTI, Vinicius Carlos; PEREIRA, Mayra Caleffi; PLETSCH-ASSUNCAO, Renata; MACCHIONE, Marcelo Ceneviva; SANTANA, Pauliane Vieira; CARDENAS, Leticia Zumpano; CARUSO, Pedro; CARVALHO, Carlos Roberto Ribeiro; ALBUQUERQUE, Andre Luis Pereira
conferenceObject Adjusting The Optimum Pressure Support Through The Work Of Breathing To Avoid The Over-Assistance(2015) PLETSCH, R.; ALBUQUERQUE, A. L.; CARDENAS, L. Z.; FERREIRA, J. G.; PEREIRA, M. C.; CARVALHO, C. R. R.; CARUSO, P.- Unilateral diaphragm paralysis: a dysfunction restricted not just to one hemidiaphragm(2018) CALEFFI-PEREIRA, Mayra; PLETSCH-ASSUNCAO, Renata; CARDENAS, Leticia Zumpano; SANTANA, Pauliane Vieira; FERREIRA, Jeferson George; IAMONTI, Vinicius Carlos; CARUSO, Pedro; FERNANDEZ, Angelo; CARVALHO, Carlos Roberto Ribeiro de; ALBUQUERQUE, Andre Luis PereiraBackground: Most patients with unilateral diaphragm paralysis (UDP) have unexplained dyspnea, exercise limitations, and reduction in inspiratory muscle capacity. We aimed to evaluate the generation of pressure in each hemidiaphragm separately and its contribution to overall inspiratory strength. Methods: Twenty-seven patients, 9 in right paralysis group (RP) and 18 in left paralysis group (LP), with forced vital capacity (FVC) < 80% pred, and 20 healthy controls (CG), with forced expiratory volume in 1 s (FEV1) > 80% pred and FVC > 80% pred, were evaluated for lung function, maximal inspiratory (MIP) and expiratory (MEP) pressure measurements, diaphragm ultrasound, and transdiaphragmatic pressure during magnetic phrenic nerve stimulation (Pdi(Tw)). Results: RP and LP had significant inspiratory muscle weakness compared to controls, detected by MIP (-57.4 +/- 16.9 for RP; -67.1 +/- 28.5 for LP and -103.1 +/- 30.4 cmH(2)O for CG) and also by Pdi(TW) (5.7 +/- 4 for RP; 4.8 +/- 2.3 for LP and 15.3 +/- 5.7 cmH(2)O for CG). The PdiTw was reduced even when the non-paralyzed hemidiaphragm was stimulated, mainly due to the low contribution of gastric pressure (around 30%), regardless of whether the paralysis was in the right or left hemidiaphragm. On the other hand, in CG, esophagic and gastric pressures had similar contribution to the overall Pdi (around 50%). Comparing both paralyzed and non-paralyzed hemidiaphragms, the mobility during quiet and deep breathing, and thickness at functional residual capacity (FRC) and total lung capacity (TLC), were significantly reduced in paralyzed hemidiaphragm. In addition, thickness fraction was extremely diminished when contrasted with the non-paralyzed hemidiaphragm. Conclusions: In symptomatic patients with UDP, global inspiratory strength is reduced not only due to weakness in the paralyzed hemidiaphragm but also to impairment in the pressure generated by the non-paralyzed hemidiaphragm.
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.