CLAUDIA MARQUEZ SIMOES

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 24 Citação(ões) na Scopus
    A pragmatic multi-center trial of goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery
    (2017) MALBOUISSON, Luiz Marcelo Sa; SILVA JR., Joao Manoel; CARMONA, Maria Jose Carvalho; LOPES, Marcel Rezende; ASSUNCAO, Murilo Santucci; VALIATTI, Jorge Luis dos Santos; SIMOES, Claudia Marques; AULER JR., Jose Otavio Costa
    Background: Intraoperative fluid therapy guided by mechanical ventilation-induced pulse-pressure variation (PPV) may improve outcomes after major surgery. We tested this hypothesis in a multi-center study. Methods: The patients were included in two periods: a first control period (control group; n = 147) in which intraoperative fluids were given according to clinical judgment. After a training period, intraoperative fluid management was titrated to maintain PPV < 10% in 109 surgical patients (PPV group). We performed 1:1 propensity score matching to ensure the groups were comparable with regard to age, weight, duration of surgery, and type of operation. The primary endpoint was postoperative hospital length of stay. Results: After matching, 84 patients remained in each group. Baseline characteristics, surgical procedure duration and physiological parameters evaluated at the start of surgery were similar between the groups. The volume of crystalloids (4500 mL [3200-6500 mL] versus 5000 mL [3750-8862 mL]; P = 0.01), the number of blood units infused during the surgery (1.7 U [0.9-2.0 U] versus 2.0 U [1.7-2.6 U]; P = 0.01), the fraction of patients transfused (13.1% versus 32.1%; P = 0.003) and the number of patients receiving mechanical ventilation at 24 h (3.2% versus 9.7%; P = 0.027) were smaller postoperatively in PPV group. Intraoperative PPV-based improved the composite outcome of postoperative complications OR 0.59 [95% CI 0.35-0.99] and reduced the postoperative hospital length of stay (8 days [6-14 days] versus 11 days [7-18 days]; P = 0.01). Conclusions: In high-risk surgeries, PPV-directed volume loading improved postoperative outcomes and decreased the postoperative hospital length of stay.
  • bookPart
    Hipertermia Maligna
    (2017) SIMõES, Claudia Marquez; CUNHA, Luiz Bonfim Pereira da; CAGNOLATI, Daniel Carlos
  • bookPart
    Qual é o benefício da anestesia venosa comparada com a anestesia inalatória em cirurgia torácica durante a ventilação monopulmonar?
    (2017) ALVAREZ, Nora Elizabeth Rojas; VIEIRA, Joaquim Edson; BERNARDO, Wanderley Marques; SIMõES, Claudia Marquez
  • bookPart
    Gestão de risco e desfechos em anestesia
    (2017) SIMõES, Claudia Marquez; OLIVEIRA, Daiane da Silva; JúNIOR, José Otávio Costa Auler