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366 results on '"Marcelo Gama de Abreu"'

352. VAPORIZED PERFLUOROHEXANE VS. PARTIAL LIQUID VENTILATION IN EXPERIMENTAL LUNG INJURY

Author

Peter M. Spieth, Marcelo Gama de Abreu, J rg-Uwe Bleyl, Andr Domingues Quelhas, Matthias H bler, Antonio Giannella-Neto, G tz Br uer, Fernando A. Bozza, Thea Koch, Lilla Knels, Eberhard Kuhlisch, Jorge I. F. Salluh, Alexandre Visintainer Pino, Michael Kasper, and B rbel Wiedemann

Subjects
business.industry, Biomedical Engineering, Biophysics, Bioengineering, General Medicine, Lung injury, Biomaterials, chemistry.chemical_compound, chemistry, Anesthesia, Medicine, Partial liquid ventilation, business, Perfluorohexane
Published
2006

355. PULMONARY CAPILLARY BLOOD FLOW BY PARTIAL CO2 REBREATHING

Author

Max Ragaller, Marcelo Gama de Abreu, D. M. Albrecht, Stefan Geiger, and Tilo Winkler

Subjects
business.industry, Capillary action, Medicine, Blood flow, Critical Care and Intensive Care Medicine, business, Biomedical engineering
Published
1998

357. Brazilian Consensus on perioperative hemodynamic therapy goal guided in patients undergoing noncardiac surgery: fluid management strategy – produced by the São Paulo State Society of Anesthesiology (Sociedade de Anestesiologia do Estado de São Paulo – SAESP)

Author

Luiz Antônio Mondadori, Marcelo Gama de Abreu, Bobbie Jean Sweitzer, Roseny dos Reis Rodrigues, Filomena Regina Barbosa Gomes Galas, Francisco R. M. Lobo, Murillo Santucci Cesar de Assunção, Marcelo Vaz Perez, Ludhmila Abrahão Hajjar, João Manoel Silva Junior, Enis Donizetti Silva, Alexandre Teruya, Rogean Rodrigues Nunes, Regina El Dib, Chiara Scaglioni Tessmer Gatto, Albert C. Perrino, Luciano Cesar Pontes Azevedo, Paulo do Nascimento, Leandro Ultino Taniguchi, Claudia Marquez Simões, Suzana Margareth Lobo, E Rezende, Hospital Sírio Libanês, Sociedade de Anestesiologia do Estado de São Paulo, Sociedade Brasileira de Anestesiologia, Yale University, Hospital de Transplantes do Estado de São Paulo Euryclides de Jesus Zerbini, Hospital Israelita Albert Einstein, Hospital Moriah, University of Chicago, Universidade de São Paulo (USP), Hospital do Servidor Público Estadual, Faculdade de Medicina de São José do Rio Preto, Hospital de Base de São José do Rio Preto, A. C. Camargo Cancer Center, University Hospital Carl Gustav Carus, Santa Casa de São Paulo, Universidade Federal de São Paulo, Universidade Estadual Paulista (Unesp), Associação de Medicina Intensiva Brasileira, Hospital Geral de Fortaleza, and Centro Universitário Christus

Subjects
medicine.medical_specialty, Consensus, Hemodynamics, Guidelines as Topic, Fluid management, lcsh:RD78.3-87.3, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, medicine, Humans, In patient, Anesthesia, Intensive care medicine, business.industry, 030208 emergency & critical care medicine, General Medicine, Perioperative, lcsh:Anesthesiology, Surgical Procedures, Operative, Emergency medicine, Fluid Therapy, business, Noncardiac surgery, Goals, Brazil
Abstract

Made available in DSpace on 2021-07-14T10:19:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2016. Added 1 bitstream(s) on 2021-07-14T11:26:58Z : No. of bitstreams: 1 S0034-70942016000600557.pdf: 1000177 bytes, checksum: ae239271c82bc883199572ee56b11e0c (MD5) Hospital Sírio Libanês Sociedade de Anestesiologia do Estado de São Paulo Sociedade Brasileira de Anestesiologia Yale University, School of Medicine Hospital de Transplantes do Estado de São Paulo Euryclides de Jesus Zerbini Hospital Israelita Albert Einstein Hospital Moriah University of Chicago, Northwestern School of Medicine Universidade de São Paulo, Faculdade de Medicina Hospital do Servidor Público Estadual Faculdade de Medicina de São José do Rio Preto Hospital de Base de São José do Rio Preto Hospital Sírio Libanês, Instituto de Ensino e Pesquisa A. C. Camargo Cancer Center University Hospital Carl Gustav Carus Santa Casa de São Paulo, Faculdade de Ciências Médicas Universidade Federal de São Paulo Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Anestesiologia Associação de Medicina Intensiva Brasileira Hospital Geral de Fortaleza Centro Universitário Christus, Faculdade de Medicina Universidade Estadual Paulista “Júlio de Mesquita Filho”, Departamento de Anestesiologia

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358. Comparison between effects of pressure support and pressure-controlled ventilation on lung and diaphragmatic damage in experimental emphysema

Author

Marcelo Gama de Abreu, Vera Luiza Capelozzi, Lucas Felipe Bastos Horta, Gisele A. Padilha, Cintia L. Santos, Cassia L. Braga, Pedro L. Silva, Paolo Pelosi, Lillian Moraes, Isalira Peroba Ramos, Milena V. Oliveira, Regina Coeli dos Santos Goldenberg, Marcelo M. Morales, and Patricia R. M. Rocco

Subjects
Cardiac function curve, medicine.medical_treatment, Diaphragm, Pressure controlled ventilation, Diaphragmatic breathing, Pressure support ventilation, Critical Care and Intensive Care Medicine, Amphiregulin, 03 medical and health sciences, 0302 clinical medicine, medicine, Mechanical ventilation, Emphysema, Lung, business.industry, Research, 030208 emergency & critical care medicine, respiratory system, Diaphragm (structural system), respiratory tract diseases, Echocardiography, medicine.anatomical_structure, 030228 respiratory system, Anesthesia, Breathing, business
Abstract

Background In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. Methods Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks. Control animals received saline under the same protocol. Eight weeks after first instillation, control and emphysema rats were randomly assigned to PCV (n = 6/each) or PSV (n = 6/each) under protective tidal volume (6 ml/kg) for 4 h. Non-ventilated control and emphysema animals (n = 6/group) were used to characterize the model and for molecular biology analysis. Cardiorespiratory function, lung histology, diaphragm ultrastructure alterations, extracellular matrix organization, diaphragmatic proteolysis, and biological markers associated with pulmonary inflammation, alveolar stretch, and epithelial and endothelial cell damage were assessed. Results Emphysema animals exhibited cardiorespiratory changes that resemble human emphysema, such as increased areas of lung hyperinflation, pulmonary amphiregulin expression, and diaphragmatic injury. In emphysema animals, PSV compared to PCV yielded: no changes in gas exchange; decreased mean transpulmonary pressure (Pmean,L), ratio between inspiratory and total time (Ti/Ttot), lung hyperinflation, and amphiregulin expression in lung; increased ratio of pulmonary artery acceleration time to pulmonary artery ejection time, suggesting reduced right ventricular afterload; and increased ultrastructural damage to the diaphragm. Amphiregulin correlated with Pmean,L (r = 0.99, p

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359. Expanded endothelial progenitor cells mitigate lung injury in septic mice

Author

A. Güldner, Johnatas D. Silva, Soraia C. Abreu, Patty Rose da Silva Barcelos, Debora G. Xisto, Patricia R. M. Rocco, Alexandra Cristina Senegaglia, Paulo Roberto Slud Brofman, Tatiana Maron-Gutierrez, and Marcelo Gama de Abreu

Subjects
Pathology, medicine.medical_specialty, medicine.medical_treatment, Short Report, Medicine (miscellaneous), Inflammation, Lung injury, Biology, Biochemistry, Genetics and Molecular Biology (miscellaneous), Sepsis, Mice, chemistry.chemical_compound, Antigens, CD, medicine, Animals, Humans, AC133 Antigen, Progenitor cell, Diffuse alveolar damage, Lung, Cell Proliferation, Endothelial Progenitor Cells, Glycoproteins, Mice, Inbred BALB C, Cell therapies, Growth factor, Lung Injury, Cell Biology, Fetal Blood, medicine.disease, Respiratory Function Tests, Vascular endothelial growth factor, Phenotype, chemistry, embryonic structures, cardiovascular system, Intercellular Signaling Peptides and Proteins, Molecular Medicine, Tumor necrosis factor alpha, Inflammation Mediators, medicine.symptom, Peptides, Growth factors, circulatory and respiratory physiology
Abstract

Endothelial progenitor cells (EPCs) improve survival and reduce organ failure in cecal ligation and puncture-induced sepsis; however, expanded EPCs may represent an even better approach for vascular repair. To date, no study has compared the effects of non-expanded EPCs (EPC-NEXP) with those of expanded EPCs (EPC-EXP) and mesenchymal stromal cells of human (MSC-HUMAN) and mouse (MSC-MICE) origin in experimental sepsis. One day after cecal ligation and puncture sepsis induction, BALB/c mice were randomized to receive saline, EPC-EXP, EPC-NEXP, MSC-HUMAN or MSC-MICE (1 × 105) intravenously. EPC-EXP, EPC-NEXP, MSC-HUMAN, and MSC-MICE displayed differences in phenotypic characterization. On days 1 and 3, cecal ligation and puncture mice showed decreased survival rate, and increased elastance, diffuse alveolar damage, and levels of interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor-α, vascular endothelial growth factor, and platelet-derived growth factor in lung tissue. EPC-EXP and MSC-HUMAN had reduced elastance, diffuse alveolar damage, and platelet-derived growth factor compared to no-cell treatment. Tumor necrosis factor-α levels decreased in the EPC-EXP, MSC-HUMAN, and MSC-MICE groups. IL-1β levels decreased in the EPC-EXP group, while IL-10 decreased in the MSC-MICE. IL-6 levels decreased both in the EPC-EXP and MSC-MICE groups. Vascular endothelial growth factor levels were reduced regardless of therapy. In conclusion, EPC-EXP and MSC-HUMAN yielded better lung function and reduced histologic damage in septic mice. Electronic supplementary material The online version of this article (doi:10.1186/s13287-015-0226-7) contains supplementary material, which is available to authorized users.

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360. Perfluorohexane vapor has only minor effects on spatial pulmonary blood flow distribution in isolated rabbit lungs

Author

Thomas Rössel, Jörg U. Bleyl, Tobias Kroll, Marcelo Gama de Abreu, Thea Koch, Axel R. Heller, and Matthias Hübler

Subjects
Male, Pulmonary Circulation, Respiratory rate, In Vitro Techniques, chemistry.chemical_compound, Afterload, Chinchilla, Animals, Medicine, Lung, Tidal volume, Perfluorohexane, Fluorocarbons, Lagomorpha, biology, Pulmonary Gas Exchange, business.industry, Organ Size, Blood flow, biology.organism_classification, Anesthesiology and Pain Medicine, medicine.anatomical_structure, chemistry, Anesthesia, Room air distribution, Female, Rabbits, business, Nuclear medicine, Algorithms
Abstract

We tested the hypothesis that administration of perfluorohexane (PFH) vapor does not significantly affect the relative pulmonary blood flow (𝑄rel) distribution in isolated rabbit lungs. Fourteen isolated rabbit lungs were perfused with a Krebs-Henseleit buffer solution (flow 150 mL/min). Pulmonary afterload was set to 3 mm Hg. The lungs were ventilated with 4% CO2 in room air using a small animal ventilator (respiratory rate, 30 breaths/min; tidal volume, 12 mL/kg body weight; positive end-expiratory pressure, 2 cm H2O). After a steady-state period, 18 vol. % of PFH vapor was administered to 9 lungs for 30 min. In a second set of experiments five lungs served as controls. Change in 𝑄rel distribution was assessed using fluorescent-labeled microspheres. The unpaired Student's t-test was used to compare variables between groups. The paired Student's t-test, the one-sample Student's t-test, the Anderson-Hauck test of equivalence, and Pearson correlation were used to analyze changes within groups. The mean correlation coefficients of 𝑄rel were 0.564 ± 0.182 for the PFH group and 0.502 ± 0.295 for the control group, respectively. No significant changes in 𝑄rel distribution over time and between groups were found. However, in the PFH group a tendency towards redistribution of 𝑄rel to more ventral lung areas was noted. Our results suggest that PFH vapor has no significant effects on redistribution of 𝑄rel in isolated rabbit lungs.

361. Protocol for a systematic review and individual patient data meta-analysis of benefit of so-called lung-protective ventilation settings in patients under general anesthesia for surgery

Author

Marcus J. Schultz, Ary Serpa Neto, Marcelo Gama de Abreu, Paolo Pelosi, Sabrine N.T. Hemmes, Intensive Care Medicine, Amsterdam institute for Infection and Immunity, and Anesthesiology

Subjects
medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Medicine (miscellaneous), Anesthesia, General, Lung injury, Positive-Pressure Respiration, Intraoperative Period, Mechanical ventilation, Protocol, Tidal Volume, Humans, Medicine, Intensive care medicine, Tidal volume, Protocol (science), business.industry, Lung protective ventilation, respiratory system, Respiration, Artificial, respiratory tract diseases, Surgery, Surgical Procedures, Operative, Anesthesia, Meta-analysis, Breathing, Individual patient data, lung-protective ventilation, business, Protective ventilation, Systematic Reviews as Topic, circulatory and respiratory physiology
Abstract

Background Almost all patients under general anesthesia for surgery need mechanical ventilation. The harmful effects of short-term intra-operative ventilation on pulmonary integrity are increasingly recognized. Recent investigations suggest protection against so-called ventilation-associated lung injury with the use of lower tidal volumes and/or the use of higher levels of positive end-expiratory pressure (PEEP). This review and meta-analysis will evaluate the effects of these protective measures on pulmonary and extra-pulmonary complications, and try to discriminate the effects of lower tidal volumes from those of higher levels of PEEP. Methods/design The Medline database will be searched for observational studies and randomized controlled trials of intra-operative ventilation. Individual patient data will be collected from databases obtained via direct contact with corresponding authors of original articles. The primary endpoint is development of postoperative acute respiratory distress syndrome, the most important postoperative pulmonary complication. Secondary endpoints include hospital length of stay and hospital mortality, and reported intra-operative and postoperative pulmonary and extra-pulmonary complications. Emphasis is put on separating the effects of lower tidal volumes from those of higher levels of PEEP. Discussion This will be the first meta-analysis of intra-operative ventilation using individual patient data from observational studies and randomized controlled trials. The large sample size could allow discrimination of the effect of the two most frequently used protective measures - that is, lower tidal volumes and higher levels of PEEP. The results of this review and meta-analysis can be used in designing future trials of ventilation.

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362. EFFECTS OF PRESSURE CONTROL AND PRESSURE SUPPORT VENTILATION ON VENTILATOR INDUCED LUNG INJURY IN EXPERIMENTAL ACUTE RESPIRATORY DISTRESS SYNDROME WITH INTRA-ABDOMINAL HYPERTENSION

Author

Nathane S. Felix, Marcelo Gama de Abreu, P.R.M. Rocco, Lillian Moraes, Pedro L. Silva, Cintia L. Santos, PL Fiorio Júnior, Paolo Pelosi, Cynthia S. Samary, Raquel S. Santos, Alberto Schanaider, and Marcelo M. Morales

Subjects
Mechanical ventilation, ARDS, business.industry, medicine.medical_treatment, Pressure support ventilation, Atelectasis, Respiratory physiology, respiratory system, Lung injury, Critical Care and Intensive Care Medicine, medicine.disease, respiratory tract diseases, Anesthesia, Poster Presentation, Breathing, Medicine, Respiratory function, business
Abstract

In acute respiratory distress syndrome (ARDS), intra-abdominal hypertension (IAH) increases intra-thoracic pressures, leading atelectasis and deterioration of respiratory mechanics and gas-exchange. The optimal setting of mechanical ventilation (MV) and its impact on respiratory function and ventilator-induced lung injury (VILI) in ARDS associated with IAH needs to be better clarified. Lung-protective MV with low tidal volume (VT) and positive end-expiratory pressure (PEEP) has been recommended; however, assisted MV may be a favorable alternative to controlled MV at the early phase of ARDS, since it requires less sedation, no paralysis and is associated with better lung protection, reducing the risk of VILI. We hypothesized that pressure-support ventilation (PSV) improve pulmonary morphofunction and minimize lung injury in ARDS with IAH.

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363. Associations of dynamic driving pressure and mechanical power with postoperative pulmonary complications–posthoc analysis of two randomised clinical trials in open abdominal surgery

Author

Michiel T.U. Schuijt, Liselotte Hol, Sunny G. Nijbroek, Sanchit Ahuja, David van Meenen, Guido Mazzinari, Sabrine Hemmes, Thomas Bluth, Lorenzo Ball, Marcelo Gama–de Abreu, Paolo Pelosi, Marcus J. Schultz, and Ary Serpa Neto

Subjects
Mechanical ventilation, Postoperative pulmonary complication, Driving pressure, Mechanical power, Intraoperative, Intensity of ventilation, Medicine (General), R5-920
Abstract

Summary: Background: While an association of the intraoperative driving pressure with postoperative pulmonary complications has been described before, it is uncertain whether the intraoperative mechanical power is associated with postoperative pulmonary complications. Methods: Posthoc analysis of two international, multicentre randomised clinical trials (ISRCTN70332574 and NCT02148692) conducted between 2011–2013 and 2014–2018, in patients undergoing open abdominal surgery comparing the effect of two different positive end–expiratory pressure (PEEP) levels on postoperative pulmonary complications. Time–weighted average dynamic driving pressure and mechanical power were calculated for individual patients. A multivariable logistic regression model adjusted for confounders was used to assess the independent associations of driving pressure and mechanical power with the occurrence of a composite of postoperative pulmonary complications, the primary endpoint of this posthoc analysis. Findings: In 1191 patients included, postoperative pulmonary complications occurrence was 35.9%. Median time–weighted average driving pressure and mechanical power were 14·0 [11·0–17·0] cmH2O, and 7·6 [5·1–10·0] J/min, respectively. While driving pressure was not independently associated with postoperative pulmonary complications (odds ratio, 1·06 [95% CI 0·88–1·28]; p=0.534), the mechanical power had an independent association with the occurrence of postoperative pulmonary complications (odds ratio, 1·28 [95% CI 1·05–1·57]; p=0.016). These findings were independent of body mass index or the level of PEEP used, i.e., independent of the randomisation arm. Interpretation: In this merged cohort of surgery patients, higher intraoperative mechanical power was independently associated with postoperative pulmonary complications. Mechanical power could serve as a summary ventilatory biomarker for the risk for postoperative pulmonary complications in these patients, but our findings need confirmation in other, preferably prospective studies. Funding: The two original studies were supported by unrestricted grants from the European Society of Anaesthesiology and the Amsterdam University Medical Centers, Location AMC. For this current analysis, no additional funding was requested. The funding sources had neither a role in the design, collection of data, statistical analysis, interpretation of data, writing of the report, nor in the decision to submit the paper for publication.

Published
2022
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365. The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Author

Mazzinari, G., Serpa Neto, A., Hemmes, S. N. T., Hedenstierna, G., Jaber, S., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Pearse, R. M., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., Cambronero, O. D., Ball, L., de Abreu, M. G., Pelosi, P., Schultz, M. J., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., van Mossevelde, V., van Malderen, M. -C., Dylst, D., van Melkebeek, J., Beran, M., de Hert, S., De Baerdemaeker, L., Heyse, B., Van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., van de Velde, S., Leva, B., Damster, S., Plichon, B., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Saric, J. P., Erceg, G., Dvorscak, M. B., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., el Kafrawy, S., Abdelwahab, H. H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Hasan, W. F., Ahmed, A. G., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Gueldner, A., Spieth, P., Scharffenberg, M., Thiem, D. T., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. -K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Hemmes, S., Schultz, M., Hollmann, M., Wiersma, I., Binnekade, J., Bos, L., Boer, C., Duvekot, A., in 't Veld, B., Werger, A., Dennesen, P., Severijns, C., De Jong, J., Hering, J., van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Hodt, K. S., Fjellanger, F., Avalos, M. V., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G., Ferreira, D., Amaral, J., de Lurdes Goncalves Castro, M., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Garotescu, I. P., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. -T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. -M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, S. G., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, M. C., Puigbo, C., Fava, J., Canet, J., Moret, E., Rodriguez Nunez, M., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Martinez, F. H., Temino, M. J. Y., Martinez Simon, A., de Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Vivo, J. T., Ruiz, C. S., de Andres Ibanez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Alvares-Santullano, C. A., Perez, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Bengisun, Z. K., Kazbek, B. K., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ozgen, S. U., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Karaman, F. M., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Pearse, R., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Mills, G., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Melo, M. V., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Mazzinari G., Serpa Neto A., Hemmes S.N.T., Hedenstierna G., Jaber S., Hiesmayr M., Hollmann M.W., Mills G.H., Vidal Melo M.F., Pearse R.M., Putensen C., Schmid W., Severgnini P., Wrigge H., Cambronero O.D., Ball L., de Abreu M.G., Pelosi P., Schultz M.J., Kroell W., Metzler H., Struber G., Wegscheider T., Gombotz H., Urbanek B., Kahn D., Momeni M., Pospiech A., Lois F., Forget P., Grosu I., Poelaert J., van Mossevelde V., van Malderen M.-C., Dylst D., van Melkebeek J., Beran M., de Hert S., De Baerdemaeker L., Heyse B., Van Limmen J., Wyffels P., Jacobs T., Roels N., De Bruyne A., van de Velde S., Leva B., Damster S., Plichon B., Juros-Zovko M., Djonovic-Omanovic D., Pernar S., Zunic J., Miskovic P., Zilic A., Kvolik S., Ivic D., Azenic-Venzera D., Skiljic S., Vinkovic H., Oputric I., Juricic K., Frkovic V., Kopic J., Mirkovic I., Karanovic N., Carev M., Dropulic N., Saric J.P., Erceg G., Dvorscak M.B., Mazul-Sunko B., Pavicic A.M., Goranovic T., Maldini B., Radocaj T., Gavranovic Z., Mladic-Batinica I., Sehovic M., Stourac P., Harazim H., Smekalova O., Kosinova M., Kolacek T., Hudacek K., Drab M., Brujevic J., Vitkova K., Jirmanova K., Volfova I., Dzurnakova P., Liskova K., Dudas R., Filipsky R., el Kafrawy S., Abdelwahab H.H., Metwally T., Abdel-Razek A., El-Shaarawy A.M., Hasan W.F., Ahmed A.G., Yassin H., Magdy M., Abdelhady M., Mahran M., Herodes E., Kivik P., Oganjan J., Aun A., Sormus A., Sarapuu K., Mall M., Karjagin J., Futier E., Petit A., Gerard A., Marret E., Solier M., Prades A., Krassler J., Merzky S., Uhlig C., Kiss T., Bundy A., Bluth T., Gueldner A., Spieth P., Scharffenberg M., Thiem D.T., Koch T., Treschan T., Schaefer M., Bastin B., Geib J., Weiss M., Kienbaum P., Pannen B., Gottschalk A., Konrad M., Westerheide D., Schwerdtfeger B., Simon P., Reske A., Nestler C., Valsamidis D., Stroumpoulis K., Antholopoulos G., Andreou A., Karapanos D., Theodoraki 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S.-M., Copotoiu R., Barsan V., Tolcser Z., Riciu M., Moldovan S.G., Veres M., Gritsan A., Kapkan T., Gritsan G., Korolkov O., Kulikov A., Lubnin A., Ovezov A., Prokoshev P., Lugovoy A., Anipchenko N., Babayants A., Komissarova I., Zalina K., Likhvantsev V., Fedorov S., Lazukic A., Pejakovic J., Mihajlovic D., Kusnierikova Z., Zelinkova M., Bruncakova K., Polakovicova L., Sobona V., Novak-Supe B., Pekle-Golez A., Jovanov M., Strazisar B., Markovic-Bozic J., Novak-Jankovic V., Voje M., Grynyuk A., Kostadinov I., Spindler-Vesel A., Moral V., Unzueta M.C., Puigbo C., Fava J., Canet J., Moret E., Rodriguez Nunez M., Sendra M., Brunelli A., Rodenas F., Monedero P., Martinez F.H., Temino M.J.Y., Martinez Simon A., de Abajo Larriba A., Lisi A., Perez G., Martinez R., Granell M., Vivo J.T., Ruiz C.S., de Andres Ibanez J.A., Pastor E., Soro M., Ferrando C., Defez M., Alvares-Santullano C.A., Perez R., Rico J., Jawad M., Saeed Y., Gillberg L., Bengisun Z.K., Kazbek B.K., Coskunfirat N., Boztug N., Sanli S., Yilmaz M., Hadimioglu N., Senturk N.M., Camci E., Kucukgoncu S., Sungur Z., Sivrikoz N., Ozgen S.U., Toraman F., Selvi O., Senturk O., Yildiz M., Kuvaki B., Gunenc F., Kucukguclu S., Ozbilgin S., Maral J., Canli S., Arun O., Saltali A., Aydogan E., Akgun F.N., Sanlikarip C., Karaman F.M., Mazur A., Vorotyntsev S., Rousseau G., Barrett C., Stancombe L., Shelley B., Scholes H., Limb J., Rafi A., Wayman L., Deane J., Rogerson D., Williams J., Yates S., Rogers E., Pulletz M., Moreton S., Jones S., Venkatesh S., Burton M., Brown L., Goodall C., Rucklidge M., Fuller D., Nadolski M., Kusre S., Lundberg M., Everett L., Nutt H., Zuleika M., Carvalho P., Clements D., Creagh-Brown B., Watt P., Raymode P., Pearse R., Mohr O., Raj A., Creary T., Chishti A., Bell A., Higham C., Cain A., Gibb S., Mowat S., Franklin D., West C., Minto G., Boyd N., Mills G., Calton E., Walker R., Mackenzie F., Ellison B., Roberts H., Chikungwa M., Jackson C., Donovan A., Foot J., Homan E., Montgomery J., Portch D., Mercer P., Palmer J., Paddle J., Fouracres A., Datson A., Andrew A., Welch L., Rose A., Varma S., Simeson K., Rambhatla M., Susarla J., Marri S., Kodaganallur K., Das A., Algarsamy S., Colley J., Davies S., Szewczyk M., Smith T., Fernandez-Bustamante A., Luzier E., Almagro A., Melo M.V., Fernando L., Sulemanji D., Sprung J., Weingarten T., Kor D., Scavonetto F., Tze Y., Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Guido, Mazzinari, Ary Serpa, Neto, Sabrine N, T Hemme, Goran, Hedenstierna, Samir, Jaber, Michael, Hiesmayr, Markus, W Hollmann, Gary, H Mill, Marcos, F Vidal Melo, Rupert, M Pearse, Christian, Putensen, Werner, Schmid, Paolo, Severgnini, Hermann, Wrigge, Oscar Diaz, Cambronero, Lorenzo, Ball, Marcelo Gama de, Abreu, Paolo, Pelosi, Marcus, J Schultz (LAS VEGAS study–investigator, PROtective VEntilation, Network, Clinical Trial Network of the European Society of, Anaesthesiology), Zangrillo, A, Landoni, G, Beretta, L, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pulmonary medicine, IOO, ACS - Microcirculation, ACS - Heart failure & arrhythmias, ACS - Diabetes & metabolism, study–investigators, LAS VEGAS, NETwork, PROtective VEntilation, Anaesthesiology, Clinical Trial Network of the European Society of, Mazzinari, Guido, Serpa Neto, Ary, Hemmes, Sabrine N T, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Pearse, Rupert M, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus, J, Servillo, G, Vargas, M, Intensive Care Medicine, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, Pulmonology, and APH - Global Health

Subjects
Driving pressure, Laparoscopic surgery, Laparoscopy, PEEP, Perioperative ventilation, Pneumoperitoneum, Protective ventilation, Respiratory mechanics, Lung Diseases, Male, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cohort Studies, Positive-Pressure Respiration, Postoperative Complications, 0302 clinical medicine, 030202 anesthesiology, Abdomen, Clinical endpoint, Middle Aged, 3. Good health, Driving pressure, Laparoscopic surgery, Laparoscopy, PEEP, Perioperative ventilation, Pneumoperitoneum, Protective ventilation, Respiratory mechanics, Female, Research Article, Cohort study, Adult, medicine.medical_specialty, Anestesi och intensivvård, Anesthesia, General, NO, lcsh:RD78.3-87.3, 03 medical and health sciences, medicine, Humans, Propensity Score, Adverse effect, Aged, Retrospective Studies, Anesthesiology and Intensive Care, business.industry, Kirurgi, 030208 emergency & critical care medicine, Odds ratio, medicine.disease, Respiration, Artificial, Surgery, Anesthesiology and Pain Medicine, lcsh:Anesthesiology, Relative risk, business, Abdominal surgery
Abstract

Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time–weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events. Methods Posthoc retrospective propensity score–weighted cohort analysis of patients undergoing open or closed abdominal surgery in the ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. Results The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P P P TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12– to 1.14], P P P Conclusions ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. Trial registration LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

Published
2021

366. Effects of prone position on regional distribution of lung aeration and perfusion. Analysis by electrical impedance tomography and computer tomography

Author

Marcelo do Amaral Beraldo, Marcelo Britto Passos Amato, Marcelo Gama de Abreu, Carlos Roberto Ribeiro de Carvalho, Bruno do Valle Pinheiro, and Mauro Roberto Tucci

Abstract

Introdução: A utilização da posição prona melhora significativamente a oxigenação de pacientes com síndrome do desconforto respiratório agudo (SDRA). Estudos prévios sugerem que o recrutamento das regiões pulmonares colapsadas e pobremente aeradas é um dos possíveis mecanismos responsáveis pela melhora da oxigenação, no entanto, os mesmos ainda não foram comprovados. Objetivos: Quantificar a distribuição regional da aeração e da perfusão pulmonar, em ambas as posições prona e supina, através da tomografia de impedância elétrica (TIE) e da tomografia computadorizada multislice (TC), correlacionando-as com as respectivas trocas gasosas. Métodos: Foram estudados 21 suínos, da raça Ladrasse anestesiados e em ventilação mecânica controlada. Os animais foram divididos em dois grupos, de acordo com o método de imagem. 13 animais foram estudados com a TIE (grupo TIE) e 8 animais foram estudados com a TC (grupo TC). Após a indução do modelo de lesão pulmonar (infusão intermitente de solução salina e ventilação lesiva por 3 horas), os animais foram submetidos a uma manobra de recrutamento alveolar máxima (MR) seguida por uma manobra de titulação da PEEP (MTP), realizada em passos decrementais de 2 em 2 cmH2O PEEP. Onze animais (7 no grupo TIE e 4 no grupo TC) foram randomizados para iniciar o estudo na posição supina, seguida de uma segunda MR e MTP na posição prona. Dez animais (6 no grupo TIE e 4 no grupo TC) receberam as manobras na ordem inversa. Para o estudo da perfusão foram adicionados mais sete animais (2 no grupo TIE e 5 no grupo TC) que foram submetidos à injeção rápida de solução salina hipertônica e/ou de contraste iodado respectivamente. Resultados: Não foram encontradas diferenças significativas na quantidade de tecido pulmonar colapsado e hiperdistendido, entre as posições estudadas em ambos os grupos TIE e TC (p= 0.06). Entretanto, as trocas gasosas foram consistentemente melhores durante a posição prona (p

Published
2011

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