JULIANA CARVALHO FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
15 resultados
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bookPart 0 Citação(ões) na Scopus Noninvasive ventilation interface: Influence on patient-ventilator interaction(2020) TUCCI, M. R.; COSTA, E. L. V.; FERREIRA, J. C.; NAKAMURA, M. A. M.; SOUSA, M. L. de AraújoNoninvasive ventilation (NIV) is an efficient treatment for acute respiratory failure (ARF), especially for hypercapnic patients and those with congestive heart failure. In patients at high risk of extubation failure, NIV can also be used prophylactically to avoid reintubation. Unfortunately, NIV failure can occur in up to 40% of patients, half of the time due to issues associated with the interface. In this chapter, we discuss the performance of the NIV interfaces in adult patients with ARF, the factors associated with NIV failures and strategies to avoid interface problems. We discuss the use of different types of interface, including the oronasal mask, total-face mask, and helmet and we discuss on what conditions we favor the use of each one. Additionally, we detail the influence of the ventilator type, ventilator settings, and amount of leak on NIV tolerance. © 2020 Nova Science Publishers, Inc.- Estimating risk in clinical studies: odds ratio and risk ratio(2020) FURCADA, Joaquin Maritano; PATINO, Cecilia Maria; FERREIRA, Juliana Carvalho
- Response to the letter: Esophageal pressure and potential confounders for evaluating patient-ventilator asynchrony(2020) SOUSA, Mayson Laercio de Araujo; MAGRANS, Rudys; HAYASHI, Fatima K.; BLANCH, Lluis; KACMAREK, Robert M.; FERREIRA, Juliana C.
conferenceObject Association Between Asynchrony Index During Assisted Ventilation and on the Day of the Spontaneous Breathing Trial with Extubation Failure(2020) PEREIRA, E.; SOUSA, M. L.; MAGRANS, R.; HAYASHI, F. K.; KACMAREK, R. M.; BLANCH, L.; FERREIRA, J. C.- Case series: An essential study design to build knowledge and pose hypotheses for rare and new diseases(2020) TORRES-DUQUE, C.A.; PATINO, C.M.; FERREIRA, J.C.
- Predictors of asynchronies during assisted ventilation and its impact on clinical outcomes: The EPISYNC cohort study(2020) SOUSA, Mayson Laercio de Araujo; MAGRANS, Rudys; HAYASHI, Fatima K.; BLANCH, Lluis; KACMAREK, Robert M.; FERREIRA, Juliana C.Purpose: To investigate if respiratory mechanics and other baseline characteristics are predictors of patient-ventilator asynchrony and to evaluate the relationship between asynchrony during assisted ventilation and clinical outcomes. Methods: We performed a prospective cohort study in patients under mechanical ventilation (MV). Baseline measurements included severity of illness and respiratory mechanics. The primary outcome was the Asynchrony Index (AI), defined as the number of asynchronous events divided by the number of ventilator cycles and wasted efforts. We recorded ventilator waveforms throughout the entire period of MV. Results: We analyzed 11,881 h of MV from 103 subjects. Median AI during the entire period of MV was 5.1% (IQR:2.6-8.7). Intrinsic PEEP was associated with AI (OR:1.72, 95%CI:1.1-2.68), but static compliance and airway resistance were not. Simplified Acute Physiology Score 3 (OR:1.03, 95%CI:1-1.06) was also associated with AI. Median AI was higher during assisted (5.4%, IQR:2.9-9.1) than controlled (2%, IQR:0.6-4.9) ventilation, and 22% of subjects had high incidence of asynchrony (AI=10%). Subjects with AI=10% had more extubation failure (33%) than patients with AIb10% (6%), p =.01. Conclusions: Predictors of high incidence of asynchrony were severity of illness and intrinsic PEEP. High incidence of asynchrony was associated with extubation failure, but not mortality. Trial registration: ClinicalTrials.gov, NCT02687802 (c) 2020 Elsevier Inc. All rights reserved.
- Characteristics and outcomes of patients with COVID-19 admitted to the ICU in a university hospital in Sao Paulo, Brazil - study protocol(2020) FERREIRA, Juliana C.; HO, Yeh-Li; BESEN, Bruno A. M. P.; MALBUISSON, Luiz M. S.; TANIGUCHI, Leandro U.; V, Pedro Mendes; V, Eduardo L. Costa; PARK, Marcelo; DALTRO-OLIVEIRA, Renato; ROEPKE, Roberta M. L.; JR, Joao M. Silva; CARMONA, Maria Jose C.; CARVALHO, Carlos Roberto RibeiroOBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials. gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.
- Impact of a respiratory ICU rotation on resident knowledge and confidence in managing mechanical ventilation(2020) HAYASHI, Fatima Kiyoko; AYRES, Pedro Paulo Marino Rodrigues; MORAIS, Anna Miethke; SOUSA, Mayson Laercio de Araujo; BARBAS, Carmen Silvia Valente; COSTA, Eduardo Leite Vieira; CARUSO, Pedro; FERREIRA, Juliana CarvalhoObjective: To develop and apply a competency-based test to assess learning among internal medicine residents during a respiratory ICU rotation at a university hospital. Methods: We developed a test comprising 19 multiple-choice questions regarding knowledge of mechanical ventilation (MV) and 4 self-assessment questions regarding the degree of confidence in the management of MV. The test was applied on the first and last day of a 30-day respiratory ICU rotation (pre-rotation and post-rotation, respectively). During the rotation, the residents had lectures, underwent simulator training, and shadowed physicians on daily bedside rounds focused on teaching MV management. Results: Fifty residents completed the test at both time points. The mean score increased from 6.9 +/- 1.2 (pre-rotation) to 8.6 +/- 0.8 (post-rotation; p < 0.001). On questions regarding the approach to hypoxemia, the recognition of patient-ventilator asynchrony, and the recognition of risk factors for extubation failure, the post-rotation scores were significantly higher than the pre-rotation scores. Confidence in airway management increased from 6% before the rotation to 22% after the rotation (p = 0.02), whereas confidence in making the initial MV settings increased from 31% to 96% (p < 0.001) and confidence in adjusting the ventilator modes increased from 23% to 77% (p < 0.001). Conclusions: We developed a competency-based test to assess knowledge of MV among residents before and after an rotation in a respiratory ICU. Resident performance increased significantly after the rotation, as did their confidence in caring for patients on MV.
- Systematic reviews: a brief overview(2020) CALO, Natalia Causada; FERREIRA, Juliana Carvalho; PATINO, Cecilia Maria
- Academic careers in global pulmonary and critical care medicine(2020) PAPALI, Alfred; DIAZ, Janet V.; CARTER, E. Jane; FERREIRA, Juliana C.; FOWLER, Rob; GEBREMARIAM, Tewodros H.; GORDON, Stephen B.; LEE, Burton W.; MURTHY, Srinivas; RIVIELLO, Elisabeth D.; WEST, T. Eoin; ADHIKARI, Neill K. J.