LEANDRO UTINO TANIGUCHI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
73 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 73
- NEGATIVE FLUID BALANCE IN SEPSIS: WHEN AND HOW?(2017) BESEN, Bruno Adler Maccagnan Pinheiro; TANIGUCHI, Leandro UtinoFluid resuscitation plays a fundamental role in the treatment of septic shock. Administration of inappropriately large quantities of fluid may lead to volume overload, which is increasingly recognized as an independent risk factor for morbidity and mortality in critical illness. In the early treatment of sepsis, timely fluid challenges should be given to optimize organ perfusion, but continuous positive fluid balance is discouraged. In fact, achievement of a negative fluid balance during treatment of sepsis is associated with better outcomes. This review will discuss the relationship between fluid overload and unfavorable outcomes in sepsis, and how fluid overload can be prevented and managed.
bookPart Trauma torácico(2015) TANIGUCHI, Leandro UtinobookPart Peritonite bacteriana espontânea(2017) TANIGUCHI, Leandro Utino; MARTINS, Herlon SaraivabookPart Distúrbios acidobásicos na UTI(2015) MACIEL, Alexandre Toledo; TANIGUCHI, Leandro UtinobookPart Emergências hipertensivas(2015) OLMOS, Rodrigo Díaz; MARTINS, Herlon Saraiva; TANIGUCHI, Leandro UtinoconferenceObject 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, MarciobookPart Trombose venosa profunda e tromboembolismo pulmonar(2015) TANIGUCHI, Leandro UtinobookPart Trombose venosa profunda e tromboembolismo pulmonar(2022) TANIGUCHI, Leandro Utino- Prevalence of Ventilatory Conditions for Dynamic Fluid Responsiveness Prediction in 2 Tertiary Intensive Care Units(2016) MENDES, Pedro V.; RODRIGUES, Bruno N.; MIRANDA, Leandro C.; ZAMPIERI, Fernando G.; QUEIROZ, Eduardo L.; SCHETTINO, Guilherme; AZEVEDO, Luciano C.; PARK, Marcelo; TANIGUCHI, Leandro U.Background: Dynamic parameters for fluid responsiveness obtained from heart-lung interaction during invasive mechanical ventilation require specific conditions not always present in intensive care unit (ICU) patients. The aim of this study was to examine the prevalence of these conditions in critically ill patients. Methods: We conducted a prospective observational study in 2 medical-surgical ICUs. We evaluated whether it would be possible to measure dynamic indices of fluid responsiveness when fluid expansion was administered. We recorded whether the patients were in controlled invasive mechanical ventilation with tidal volume >8 mL/kg and without arrhythmias. The proportion of patients who fulfilled these conditions was recorded. A post hoc subgroup analyses by terciles of Simplified Acute Physiology Score 3 (SAPS3) were performed. Results: A total of 826 fluid challenges were undertaken in 424 patients during the study. The use of controlled mechanical ventilation with tidal volume > 8 mL/kg and without arrhythmias occurred in only 2.9% of the patients at the time of fluid challenge episodes. There was an increase in the prevalence of these conditions as the severity of the patients also increased: lower tercile of SAPS3 (0%), intermediate tercile (2%), and higher tercile (6.9%; P < .01 Pearson chi-square test). Conclusions: Respiratory-dependent dynamic parameters for predicting fluid responsiveness in ICU may have restricted applicability in daily practice, even in more severe patients, due to low prevalence of required conditions.
- Extracorporeal membrane oxygenation for severe respiratory failure in adult patients: A systematic review and meta-analysis of current evidence(2013) ZAMPIERI, Fernando Godinho; MENDES, Pedro Vitale; RANZANI, Otavio T.; TANIGUCHI, Leandro Utino; AZEVEDO, Luciano Cesar Pontes; COSTA, Eduardo Leite Vieira; PARK, MarceloBackground: Extracorporeal membrane oxygenation (ECMO) for acute respiratory failure is still a matter of debate. Methods: We performed a structured search on Pubmed, EMBASE, Lilacs, and the Cochrane Library for randomized controlled trials and observational case-control studies with severity-paired patients, evaluating the use of ECMO on severe acute respiratory failure in adult patients. A random-effect model using DerSimonian and Laird method for variance estimator was performed to evaluate the effect of ECMO use on hospital mortality. Heterogeneity between studies was assessed with Cochran's Q statistic and Higgin's I-2. Results: Three studies were included on the metanalysis, comprising 353 patients in the main analysis, in which 179 patients were ECMO supported. One study was a randomized controlled trial and two were observational studies with a propensity score matching. The most common reason for acute respiratory failure was influenza H1N1 pneumonia (45%) and pneumonia (33%). ECMO was not associated with a reduction in hospital mortality (OR = 0.71; CI 95% = 0.34-1.47; P = 0.358). If alternative severity-pairing method presented by the two observational studies was included, a total of 478 cases were included, in which 228 received ECMO support. In the former analysis, ECMO had a benefit on hospital mortality (OR = 0.52; CI 95% = 0.35-0.76; P < 0.001). Conclusion: Extracorporeal membrane oxygenation benefit on hospital mortality is unclear. Results were sensitive to statistical analysis, and no definitive conclusion can be drawn from the available data. More studies are needed before the widespread use of ECMO can be recommended.