DENISE AYA OTSUKI
Projetos de Pesquisa
Unidades Organizacionais
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Cyclooxygenases 1 and 2 inhibition and analgesic efficacy of dipyrone at different doses or meloxicam in cats after ovariohysterectomy(2021) PEREIRA, Marco A. A.; CAMPOS, Karina D.; GONCALVES, Lucas A.; SANTOS, Rosana S. T. dos; FLOR, Patricia B.; AMBROSIO, Aline M.; OTSUKI, Denise A.; MATERA, Julia M.; GOMES, Cristina O. M. S.; FANTONI, Denise T.Objective To evaluate the cyclooxygenases (COX) inhibition, adverse effects and analgesic efficacy of dipyrone or meloxicam in cats undergoing elective ovariohysterectomy. Study design Prospective, blinded, randomized, clinical study. Animals A total of 30 healthy young cats. Methods The cats were randomly assigned to three postoperative groups: D25 (dipyrone 25 mg kg(-1) every 24 hours), D12.5 (dipyrone 12.5 mg kg(-1) every 12 hours) and M (meloxicam 0.1 mg kg(-1) every 24 hours). In the first 24 hours, the drugs were administered intravenously (IV), and then orally for 6 (dipyrone) or 3 days (meloxicam). Prostanoids thromboxane B-2 and prostaglandin E-2 concentrations served as indicators of COX activity and, with physiological variables and pain and sedation scores, were measured for 24 hours after first analgesic administration. Rescue analgesia (tramadol, 2 mg kg(-1) IV) was provided if Glasgow feline composite measure pain scale (CMPS-Feline) >= 5. Laboratory tests included symmetric dimethylarginine and adverse effects were evaluated regularly up to 7 and 10 days after surgery, respectively. Parametric and nonparametric data were analyzed with two-way ANOVA and Kruskal-Wallis tests, respectively (p < 0.05). Results In the first half hour after analgesic administration, COX-1 activity was close to zero and remained significantly lower than before drug administration for 24 hours in all groups. The inhibition of COX-2 activity was significant for 30 minutes in all groups and up to 4 hours in group M. No alterations in laboratory tests or significant adverse effects were observed. Pain scores and need for rescue analgesia did not differ statistically among groups. Conclusions Dipyrone at both doses and meloxicam provided a nonselective inhibition of COX-1 and -2 activities and effective analgesia without causing significant adverse effects or laboratory tests alterations.
- Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia(2013) IDA, Keila K.; FANTONI, Denise T.; SOUTO, Maria T. M. R.; OTSUKI, Denise A.; ZOPPA, Andre L. V.; SILVA, Luis C. L. C.; AMBROSIO, Aline M.Objective To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Study design Prospective randomized clinical study. Animals Twenty client-owned healthy horses aged 5 +/- 2years, weighing 456 +/- 90kg. Methods In the control group (CG; n=10) weaning was performed by a gradual decrease in respiratory rate (fR) and in the PSV group (PSVG; n=10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2>50 mmHg, arterial pH<7.35 plus PaCO2>50mmHg or PaO2<60mmHg were observed at any time after disconnection from the ventilator until 30minutes after the horse stood. Threshold values for each index were established and the predictive power of these values was tested. Results Pressure support ventilation group (PSVG) had (mean +/- SD) pH 7.36 +/- 0.02 and PaCO2 41 +/- 3mmHg at weaning and the average lowest PaO2 69 +/- 6mmHg was observed 15minutes post weaning. The CG had pH 7.32 +/- 0.02 and PaCO2 57 +/- 6mmHg at weaning and the average lowest PaO2 48 +/- 5mmHg at 15minutes post weaning. No accuracy in predicting weaning effect was observed for fR (p=0.3474), minute volume (p=0.1153), SaO2 (p=0.1737) and PaO2/PAO2 (p=0.1529). A high accuracy in predicting an optimal effect of weaning was observed for VT>10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p=0.0001), VT/bodyweight>18.5mL kg-1 (p=0.0001) and PaO2/FiO2>298 (p=0.0002) at weaning. A high accuracy in predicting a suboptimal effect of weaning was observed for VT<10L (p=0.0001), fR/VT ratio0.60 breaths minute-1L-1 (p= 0.0001) and PeCO238mmHg (p=0.0001) at weaning. Conclusions and clinical relevance Pressure support ventilation (PSV) weaning had a better respiratory outcome. A higher VT, VT/body weight, PaO2/FiO2 ratio and a lower fR/VT ratio and PeCO2 were accurate in predicting the effect of weaning in healthy horses recovering from general anesthesia.
- Pulse pressure variation as a guide for volume expansion in dogs undergoing orthopedic surgery(2017) FANTONI, Denise T.; IDA, Keila K.; GIMENES, Andre M.; MANTOVANI, Matheus M.; CASTRO, Jacqueline R.; PATRICIO, Geni C. F.; AMBROSIO, Aline M.; OTSUKI, Denise A.Objective To investigate whether pulse pressure variation (PPV) can predict fluid responsiveness in healthy dogs during clinical surgery. Study design Prospective clinical study. Animals Thirty-three isoflurane-anesthetized dogs with arterial hypotension during orthopedic surgery. Methods Fluid challenge with lactated Ringer's solution (15 mL kg(-1) in 15 minutes) was administered in mechanically ventilated dogs (tidal volume 10 mL kg(-1)) with hypotension [mean arterial pressure (MAP) < 65 mmHg]. The volume expansion was considered effective if cardiac output (CO; transesophageal Doppler) increased by >= 15%. Cardiopulmonary data were analyzed using two-way ANOVA, receiver operating characteristics (ROC) curves and Spearman coefficient; p < 0.05 was considered significant. Results Effective volume expansion, mean +/- standard deviation 42 +/- 4% increase in CO (p < 0.0001) was observed in 76% of the dogs, resulting in a decrease in PPV (p < 0.0001) and increase in MAP (p < 0.0001), central venous pressure (CVP; p = 0.02) and ejection fraction (p < 0.0001) compared with before the fluid challenge. None of these changes occurred when volume expansion resulted in a nonsignificant CO increase of 4 +/- 5%. No significant differences were observed in blood gas analysis between responsive and nonresponsive dogs. The increase in CO was correlated with the decrease in PPV (r = -0.65; p < 0.0001) but absolute values of CO and PPV were not correlated. The PPV performance (ROC curve area: 0.89 +/- 0.06, p = 0.0011) was better than that of CVP (ROC curve area: 0.54 +/- 0.12) and MAP (ROC curve area: 0.59 +/- 0.13) to predict fluid responsiveness. The best cut-off for PPV to distinguish responders and nonresponders was 15% (50% sensitivity and 96% specificity). Conclusions and clinical relevance In mechanically ventilated, healthy, isoflurane-anesthetized dogs, PPV predicted fluid responsiveness to volume expansion, and MAP and CVP did not show such applicability.
- Ultrasound-guided continuous block of median and ulnar nerves in horses: development of the technique(2020) SOUTO, Maria Teresa M. R.; FANTONI, Denise T.; HAMAJI, Adilson; HAMAJI, Marcelo; VENDRUSCOLO, Cynthia P.; OTSUKI, Denise A.; PINTO, Ana Carolina B. C. F.; AMBROSIO, Aline M.
- Comparison of pulse pressure variation versus echocardiography-derived stroke volume variation for prediction of fluid responsiveness in mechanically ventilated anesthetized dogs(2020) GONCALVES, Lucas A.; OTSUKI, Denise A.; PEREIRA, Marco A. A.; NAGASHIMA, Julio K.; AMBROSIO, Aline M.; FANTONI, Denise T.Objective To evaluate the ability and accuracy of aortic flow velocity-time integral variation (Delta VTI) and peak aortic velocity variation (Delta Vpeak) compared with pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated dogs. Study design Prospective clinical study. Animals A group of 50 mechanically ventilated dogs with spontaneous hypotension during orthopedic or oncologic surgery. Methods Investigations were performed in the surgery room. When mean arterial pressure (MAP) decreased to <65 mmHg, measurements were performed before and after a fluid challenge (lactated Ringer 's solution 5 mL kg(-1) over 15 minutes). Responders were defined as a change in stroke volume (SV; transesophageal Doppler) >= 15%. Data were analyzed using paired/unpaired t test or Mann-Whitney/Wilcoxon test when appropriate and receiver operating characteristics (ROC) curves; a p value <0.05 was considered statistically significant. Results After the fluid challenge, 35 (70%) of 50 dogs were responders with significant increases in SV and decreases in PPV; 15 dogs were nonresponders. Delta VTI and Delta Vpeak correlated with a 15% increase in SV. The optimum cut-off value for PPV was 15.6% (sensitivity, 88%; specificity, 100%), for Delta VTI was 10.65% (sensitivity, 65%; specificity, 100%) and for Delta Vpeak was 10.15% (sensitivity, 80%; specificity, 100%). The area under the ROC curve for PPV was (0.93 +/- 0.08) and for DVpeak was (0.89 +/- 0.09), before fluid challenge. The gray zone area spread from 6.15% to 15.6% for PPV (18 dogs), 2.45% to 10.65% for DVTI (22 dogs) and 0.6% to 10.15% for Delta Vpeak (25 dogs). Conclusions When using mechanical ventilation, Delta VTI and Delta Vpeak predicted fluid responsiveness with the same ability as PPV, based on the area under the ROC curve analysis. However, PPV showed great accuracy demonstrated by a narrower gray zone that included fewer individuals.