LUCIANO CESAR PONTES DE AZEVEDO
Projetos de Pesquisa
Unidades Organizacionais
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
8 resultados
Resultados de Busca
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conferenceObject ASSOCIATION BETWEEN EARLY FLUID BALANCE, ORGAN FAILURES AND OUTCOMES IN VENTILATED PATIENTS(2015) AZEVEDO, Luciano; IGNACIO, Fernando; SILVA, Ulysses; SOUZA-DANTAS, Vicente; TANIGUCHI, Leandro; SALLUH, Jorge; REA-NETO, Alvaro; SOARES, Marcio- Fluid balance and central venous pressure in sepsis: Small pieces in an enormous puzzle(2011) ZAMPIERI, Fernando Godinho; PARK, Marcelo; AZEVEDO, Luciano Cesar Pontes
- Sepsis: A Threat That Needs a Global Solution(2018) MACHADO, Flavia Ribeiro; AZEVEDO, Luciano Cesar Pontes
- Is the Tail Wagging the Dog in Sepsis? Reply(2018) AZEVEDO, Luciano Cesar Pontes; MACHADO, Flavia Ribeiro
- Lactated Ringer Is Associated With Reduced Mortality and Less Acute Kidney Injury in Critically III Patients: A Retrospective Cohort Analysis(2016) ZAMPIERI, Fernando G.; RANZANI, Otavio T.; AZEVEDO, Luciano Cesar Pontes; MARTINS, Izanio D. S.; KELLUM, John A.; LIBORIO, Alexandre B.Objectives: To assess the impact of the percentage of fluid infused as Lactated Ringer (%LR) during the first 2 days of ICU admission in hospital mortality and occurrence of acute kidney injury. Design: Retrospective cohort. Setting: Analysis of a large public database (Multiparameter Intelligent Monitoring in Intensive Care-II). Patients: Adult patients with at least 2 days of ICU stay, admission creatinine lower than 5 mg/dL, and that received at least 500 mL of fluid in the first 48 hours. Interventions: None. Measurement and Main Results: 10,249 patients were included in mortality analysis and 8,085 were included in the acute kidney injury analysis. For acute kidney injury analysis, we excluded patients achieving acute kidney injury criteria in the first 2 days of ICU stay. Acute kidney injury was defined as stage 2/3 Kidney Disease: Improving Global Outcomes creatinine criteria and was assessed from days 3-7. The effects of %LR in both outcomes were assessed through logistic regression controlling for confounders. Principal component analysis was applied to assess the effect of volume of each fluid type on mortality. Higher %LR was associated with lower mortality and less acute kidney injury. %LR effect increased with total volume of fluid infused. For patients in the fourth quartile of fluid volume (>7 L), the odds ratio for mortality for %LR equal to 75% versus %LR equal to 25% was 0.50 (95% CI, 0.32-0.79; p<0.001). Principal component analysis suggested that volume of Lactated Ringer and 0.9% saline infused had opposite effects in outcome, favoring Lactated Ringer. Conclusions: Higher %LR was associated with reduced hospital mortality and with less acute kidney injury from days 3-7 after ICU admission. The association between %LR and mortality was influenced by the total volume of fluids infused.
- Executive Summary: Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Septic Shock 2021(2021) EVANS, Laura; RHODES, Andrew; ALHAZZANI, Waleed; ANTONELLI, Massimo; COOPERSMITH, Craig M.; FRENCH, Craig; MACHADO, Flavia R.; MCINTYRE, Lauralyn; OSTERMANN, Marlies; PRESCOTT, Hallie C.; SCHORR, Christa; SIMPSON, Steven; WIERSINGA, W. Joost; ALSHAMSI, Fayez; ANGUS, Derek C.; ARABI, Yaseen; AZEVEDO, Luciano; BEALE, Richard; BEILMAN, Gregory; BELLEY-COTE, Emilie; BURRY, Lisa; CECCONI, Maurizio; CENTOFANTI, John; YATACO, Angel Coz; WAELE, Jan De; DELLINGER, R. Phillip; DOI, Kent; DU, Bin; ESTENSSORO, Elisa; FERRER, Ricard; GOMERSALL, Charles; HODGSON, Carol; MOLLER, Morten Hylander; IWASHYNA, Theodore; JACOB, Shevin; KLEINPELL, Ruth; KLOMPAS, Michael; KOH, Younsuck; KUMAR, Anand; KWIZERA, Arthur; LOBO, Suzana; MASUR, Henry; MCGLOUGHLIN, Steven; MEHTA, Sangeeta; MEHTA, Yatin; MER, Mervyn; NUNNALLY, Mark; OCZKOWSKI, Simon; OSBORN, Tiffany; PAPATHANASSOGLOU, Elizabeth; PERNER, Anders; PUSKARICH, Michael; ROBERTS, Jason; SCHWEICKERT, William; SECKEL, Maureen; SEVRANSKY, Jonathan; SPRUNG, Charles L.; WELTE, Tobias; ZIMMERMAN, Janice; LEVY, Mitchell
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021(2021) EVANS, Laura; RHODES, Andrew; ALHAZZANI, Waleed; ANTONELLI, Massimo; COOPERSMITH, Craig M.; FRENCH, Craig; MACHADO, Flavia R.; MCINTYRE, Lauralyn; OSTERMANN, Marlies; PRESCOTT, Hallie C.; SCHORR, Christa; SIMPSON, Steven; WIERSINGA, W. Joost; ALSHAMSI, Fayez; ANGUS, Derek C.; ARABI, Yaseen; AZEVEDO, Luciano; BEALE, Richard; BEILMAN, Gregory; BELLEY-COTE, Emilie; BURRY, Lisa; CECCONI, Maurizio; CENTOFANTI, John; YATACO, Angel Coz; WAELE, Jan De; DELLINGER, R. Phillip; DOI, Kent; DU, Bin; ESTENSSORO, Elisa; FERRER, Ricard; GOMERSALL, Charles; HODGSON, Carol; MOLLER, Morten Hylander; IWASHYNA, Theodore; JACOB, Shevin; KLEINPELL, Ruth; KLOMPAS, Michael; KOH, Younsuck; KUMAR, Anand; KWIZERA, Arthur; LOBO, Suzana; MASUR, Henry; MCGLOUGHLIN, Steven; MEHTA, Sangeeta; MEHTA, Yatin; MER, Mervyn; NUNNALLY, Mark; OCZKOWSKI, Simon; OSBORN, Tiffany; PAPATHANASSOGLOU, Elizabeth; PERNER, Anders; PUSKARICH, Michael; ROBERTS, Jason; SCHWEICKERT, William; SECKEL, Maureen; SEVRANSKY, Jonathan; SPRUNG, Charles L.; WELTE, Tobias; ZIMMERMAN, Janice; LEVY, Mitchell
- Organizational Issues, Structure, and Processes of Care in 257 ICUs in Latin America: A Study From the Latin America Intensive Care Network(2017) ESTENSSORO, Elisa; ALEGRIA, Leyla; MURIAS, Gaston; FRIEDMAN, Gilberto; CASTRO, Ricardo; VAEZA, Nicolas Nin; LOUDET, Cecilia; BRUHN, Alejandro; JIBAJA, Manuel; OSPINA-TASCON, Gustavo; RIOS, Fernando; MACHADO, Flavia R.; CAVALCANTI, Alexandre Biasi; DUBIN, Arnaldo; HURTADO, F. Javier; BRIVA, Arturo; ROMERO, Carlos; BUGEDO, Guillermo; BAKKER, Jan; CECCONI, Maurizio; AZEVEDO, Luciano; HERNANDEZ, GlennObjective: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. Design: Web-based survey submitted to ICU directors. Settings: ICUs located in nine Latin-American countries. Subjects: Individual ICUs. Interventions: None. Measurements and Main Results: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay. Seventy-nine percent of participating hospitals had less than 500 beds; most were public (59%) and academic (66%). ICUs were mainly medical-surgical (75%); number of beds was evenly distributed in the entire cohort; 77% had 24/7 intensivists; 46% had a physician-to-patient ratio between 1: 4 and 7; and 69% had a nurse-to-patient ratio of 1 >= 2.1. The 24/7 presence of other specialists was deficient. Protocols in use averaged 9 +/- 3. Brazil (vs the rest) had larger hospitals and ICUs and more quality, surveillance, and prevention committees, but fewer 24/7 intensivists and poorer nurse-to-patient ratio. Although standard monitoring, laboratory, and imaging practices were almost universal, more complex measurements and treatments and portable equipment were scarce after standard working hours, and in public hospitals. Mortality was 17.8%, without differences between countries. Conclusions: This multinational study shows major concerns in the delivery of critical care across Latin America, particularly in human resources. Technology was suboptimal, especially in public hospitals. A 24/7 availability of supporting specialists and of key procedures was inadequate. Mortality was high in comparison to high-income countries.