ANDRE LUIZ PEREIRA DE ALBUQUERQUE
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
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation(2023) LAFETA, Mariana L.; SOUZA, Vitor C.; MENEZES, Thais C. F.; VERRASTRO, Carlos G. Y.; MANCUSO, Frederico J.; ALBUQUERQUE, Andre Luis P.; TANNI, Suzana E.; IZBICKI, Meyer; CARLSTRON, Julio P.; NERY, Luiz Eduardo; OLIVEIRA, Rudolf K. F.; SPERANDIO, Priscila A.; FERREIRA, Eloara V. M.Rationale Post-coronavirus disease 2019 (COVID-19) survivors frequently have dyspnoea that can lead to exercise intolerance and lower quality of life. Despite recent advances, the pathophysiological mechanisms of exercise intolerance in the post-COVID-19 patients remain incompletely characterised. The objectives of the present study were to clarify the mechanisms of exercise intolerance in post-COVID-19 survivors after hospitalisation. Methods This prospective study evaluated consecutive patients previously hospitalised due to moderate-tosevere/critical COVID-19. Within mean +/- SD 90 +/- 10 days of onset of acute COVID-19 symptoms, patients underwent a comprehensive cardiopulmonary assessment, including cardiopulmonary exercise testing with earlobe arterialised capillary blood gas analysis. Measurements and main results 87 patients were evaluated; mean +/- SD peak oxygen consumption was 19.5 +/- 5.0 mL center dot kg(-1)center dot min(-1), and the tertiles were <= 17.0, 17.1-22.2 and >= 22.3 mL center dot kg(-1)center dot min(-1). Hospitalisation severity was similar among the three groups; however, at the follow-up visit, patients with peak oxygen consumption <= 17.0 mL center dot kg(-1)center dot min(-1) reported a greater sensation of dyspnoea, along with indices of impaired pulmonary function, and abnormal ventilatory, gas-exchange and metabolic responses during exercise compared to patients with peak oxygen consumption >17 mL center dot kg(-1)center dot min(-1). By multivariate logistic regression analysis (receiver operating characteristic curve analysis) adjusted for age, sex and prior pulmonary embolism, a peak dead space fraction of tidal volume >= 29 and a resting forced vital capacity <= 80% predicted were independent predictors of reduced peak oxygen consumption. Conclusions Exercise intolerance in the post-COVID-19 survivors was related to a high dead space fraction of tidal volume at peak exercise and a decreased resting forced vital capacity, suggesting that both pulmonary microcirculation injury and ventilatory impairment could influence aerobic capacity in this patient population.
- The Relevance of Dysautonomia on Exercise Responses(2023) LEITE, Guilherme Ward; ZIMMERMANN, Natalia de Alcantara; ALVES, Jose Leonidas; SALGE, Joao Marcos; ALBUQUERQUE, Andre Luis Pereira de
- 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
- Diaphragm Ultrasound in Critically Ill Patients on Mechanical Ventilation-Evolving Concepts(2023) SANTANA, Pauliane Vieira; CARDENAS, Leticia Zumpano; ALBUQUERQUE, Andre Luis Pereira deMechanical ventilation (MV) is a life-saving respiratory support therapy, but MV can lead to diaphragm muscle injury (myotrauma) and induce diaphragmatic dysfunction (DD). DD is relevant because it is highly prevalent and associated with significant adverse outcomes, including prolonged ventilation, weaning failures, and mortality. The main mechanisms involved in the occurrence of myotrauma are associated with inadequate MV support in adapting to the patient's respiratory effort (over- and under-assistance) and as a result of patient-ventilator asynchrony (PVA). The recognition of these mechanisms associated with myotrauma forced the development of myotrauma prevention strategies (MV with diaphragm protection), mainly based on titration of appropriate levels of inspiratory effort (to avoid over- and under-assistance) and to avoid PVA. Protecting the diaphragm during MV therefore requires the use of tools to monitor diaphragmatic effort and detect PVA. Diaphragm ultrasound is a non-invasive technique that can be used to monitor diaphragm function, to assess PVA, and potentially help to define diaphragmatic effort with protective ventilation. This review aims to provide clinicians with an overview of the relevance of DD and the main mechanisms underlying myotrauma, as well as the most current strategies aimed at minimizing the occurrence of myotrauma with special emphasis on the role of ultrasound in monitoring diaphragm function.