A5037498649- Respiratory Support and Mechanisms
- COVID-19 Clinical Research Studies
- Intensive Care Unit Cognitive Disorders
- COVID-19 and healthcare impacts
- Long-Term Effects of COVID-19
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Neonatal Respiratory Health Research
- Venous Thromboembolism Diagnosis and Management
- Mosquito-borne diseases and control
- Family and Patient Care in Intensive Care Units
- Emergency and Acute Care Studies
- Quality and Safety in Healthcare
- Simulation-Based Education in Healthcare
- Trauma and Emergency Care Studies
- Foreign Body Medical Cases
- Hospital Admissions and Outcomes
- Thermal Regulation in Medicine
- Anesthesia and Neurotoxicity Research
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Aerospace Engineering and Energy Systems
- Infection Control and Ventilation
- Viral Infections and Vectors
- Esophageal and GI Pathology
Hospital Israelita Albert Einstein
2005-2025
Universidade de São Paulo
2003-2006
Massachusetts General Hospital
2006
Hospital São Paulo
2005
Imbalances in regional lung ventilation, with gravity-dependent collapse and overdistention of nondependent zones, are likely associated to ventilator-induced injury. Electric impedance tomography is a new imaging technique that potentially capable monitoring those imbalances. The aim this study was validate electrical measurements ventilation distribution, by comparison dynamic computerized heterogeneous population critically ill patients under mechanical ventilation. Multiple scans both...
Rationale: The hypothesis that lung collapse is detrimental during the acute respiratory distress syndrome still debatable. One of difficulties lack an efficient maneuver to minimize it.Objectives: To test if a bedside recruitment strategy, capable reversing hypoxemia and in > 95% units, clinically applicable early syndrome.Methods: Prospective assessment stepwise maximum-recruitment strategy using multislice computed tomography continuous blood-gas hemodynamic monitoring.Measurements Main...
The benefits of higher positive end expiratory pressure (PEEP) in patients with acute respiratory distress syndrome (ARDS) have been modest, but few studies fully tested the "open-lung hypothesis". This hypothesis states that most collapsed lung tissue observed ARDS can be reversed at an acceptable clinical cost, potentially resulting better protection, requiring more intensive maneuvers. short-/middle-term efficacy a maximum recruitment strategy (MRS) was recently described small...
Mechanical ventilation can be a life-saving intervention, but its implementation requires multidisciplinary approach, with an understanding of indications and contraindications due to the potential for complications. The management mechanical should part curricula during clinical training; however, trainees practicing professionals frequently report low confidence in managing ventilation, often seeking additional sources knowledge. Review articles, consensus statements practice guidelines...
Recomendações brasileiras de ventilação mecânica 2013. Parte
Coagulation abnormalities in COVID-19 patients have not been addressed depth.To perform a longitudinal evaluation of coagulation profile admitted to the ICU with COVID-19.Conventional tests, rotational thromboelastometry (ROTEM), platelet function, fibrinolysis, antithrombin, protein C and S were measured at days 0, 1, 3, 7 14. Based on median total maximum SOFA score, divided two groups: ≤ 10 > 10.Thirty studied. Some conventional as aPTT, PT INR remained unchanged during study period,...
In December 2019, a series of patients with severe pneumonia were identified in Wuhan, Hubei province, China, who progressed to acute respiratory syndrome and distress syndrome. Subsequently, COVID-19 was attributed new betacoronavirus, the coronavirus 2 (SARS-CoV-2). Approximately 20% diagnosed as develop forms disease, including hypoxemic failure, syndrome, renal failure require intensive care. [...]
To describe clinical characteristics, resource use, outcomes, and to identify predictors of in-hospital mortality patients with COVID-19 admitted the intensive care unit.Retrospective single-center cohort study conducted at a private hospital in São Paulo (SP), Brazil. All consecutive adult (≥18 years) unit, between March 4, 2020 February 28, 2021 were included this study. Patients categorized survivors non-survivors according discharge.During period, 1,296 [median (interquartile range) age:...
This paper, based on relevant literature articles and the authors' clinical experience, presents a goal-oriented respiratory management for critically ill patients with acute distress syndrome (ARDS) that can help improve clinicians' ability to care these patients. Early recognition of ARDS modified risk factors avoidance aggravating during hospital stay such as nonprotective mechanical ventilation, multiple blood products transfusions, positive fluid balance, ventilator-associated...
A recent meta-analysis showed that weaning with SmartCare™ (Dräger, Lübeck, Germany) significantly decreased time in critically ill patients. However, its utility compared respiratory physiotherapist-protocolized is still a matter of debate. We hypothesized would be as effective physiotherapy-driven patients.Adult patients mechanically ventilated for more than 24 hours the adult intensive care unit Albert Einstein Hospital, São Paulo, Brazil, were randomly assigned to weaned either by...
In BriefWe compared the characteristics and outcomes of 1,427 patients with COVID-19 admitted to intensive care unit during first second waves pandemic.Both had similar mortality rates need for invasive organ support, despite in wave being younger less severely ill at time admission.
A number of complications exist with invasive mechanical ventilation and the use withdrawal from prolonged ventilator support. The protocols that enable systematic identification patients eligible for an interruption in can significantly reduce complications. This study describes application a weaning protocol its results.Patients who required more than 24 hours were included assessed daily to identify individuals ready begin process.We studied 252 median time 3.7 days (interquartile range 1...
COVID-19 is a recently identified illness that associated with thromboembolic events. We report case of pulmonary embolism in patient COVID-19, treated by catheter directed thrombectomy. A 57 year old presented to the emergency center severe symptoms and developed massive embolism. The was thrombolysis (CDT) recovered completely. Coagulopathy present all cases dynamic process. describe massive/high risk embolism, receiving full anticoagulation, who percutaneous intervention. CDT can be an...
Highlights 43.4% of the cohort developed acute kidney injury. D-dimer and fibrinogen levels were high in both groups. Rotational thromboelastometry data similar between Serum antithrombin activity protein C lower patients who Objective The incidence thrombotic events injury is critically ill with COVID-19. We aimed to evaluate compare coagulation profiles COVID-19 developing versus those [...]
There is a paucity of information about Brazilian COVID-19 in-hospital mortality probability death combining risk factors.We aimed to correlate patients' demographic aspects, biomarkers, tomographic, echocardiographic findings, and clinical events.A prospective study, single tertiary center in Brazil, consecutive patients hospitalized with COVID-19. We analyzed the data from 111 March August 2020, performed complete transthoracic echocardiogram, chest thoracic tomographic (CT) studies,...
Abstract Background: Coagulation abnormalities in severe COVID-19 patients have not been addressed depth. Methods: Prospective longitudinal single-center study involving admitted to the ICU. Conventional coagulation tests (prothrombin time, international normalized ratio and activated partial thromboplastin time), rotational thromboelastometry (ROTEM), platelet function, plasma fibrinolysis markers, antithrombin, protein C S were measured at time of inclusion (baseline), days 1, 3, 7 14...