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2. Resuscitation fluid practices in Brazilian intensive care units: a secondary analysis of Fluid-TRIPS

Author

Freitas, Flavio Geraldo Rezende de, primary, Hammond, Naomi, additional, Li, Yang, additional, Azevedo, Luciano Cesar Pontes de, additional, Cavalcanti, Alexandre Biasi, additional, Taniguchi, Leandro, additional, Gobatto, André, additional, Japiassú, André Miguel, additional, Bafi, Antonio Tonete, additional, Mazza, Bruno Franco, additional, Noritomi, Danilo Teixeira, additional, Dal-Pizzol, Felipe, additional, Bozza, Fernando, additional, Salluh, Jorge Ibrahin Figueira, additional, Westphal, Glauco Adrieno, additional, Soares, Márcio, additional, Assunção, Murillo Santucci César de, additional, Lisboa, Thiago, additional, Lobo, Suzana Margarete Ajeje, additional, Barbosa, Achilles Rohlfs, additional, Ventura, Adriana Fonseca, additional, Souza, Ailson Faria de, additional, Silva, Alexandre Francisco, additional, Toledo, Alexandre, additional, Reis, Aline, additional, Cembrane, Allan, additional, Rea Neto, Alvaro, additional, Gut, Ana Lúcia, additional, Justo, Ana Patricia Pierre, additional, Santos, Ana Paula, additional, Albuquerque, André Campos D. de, additional, Scazufka, André, additional, Rodrigues, Antonio Babo, additional, Fernandino, Bruno Bonaccorsi, additional, Silva, Bruno Goncalves, additional, Vida, Bruno Sarno, additional, Pinheiro, Bruno Valle, additional, Pinto, Bruno Vilela Costa, additional, Feijo, Carlos Augusto Ramos, additional, Abreu Filho, Carlos de, additional, Bosso, Carlos Eduardo da Costa Nunes, additional, Moreira, Carlos Eduardo Nassif, additional, Ramos, Carlos Henrique Ferreira, additional, Tavares, Carmen, additional, Arantes, Cidamaiá, additional, Grion, Cintia, additional, Mendes, Ciro Leite, additional, Kmohan, Claudio, additional, Piras, Claudio, additional, Castro, Cristine Pilati Pileggi, additional, Lins, Cyntia, additional, Beraldo, Daniel, additional, Fontes, Daniel, additional, Boni, Daniela, additional, Castiglioni, Débora, additional, Paisani, Denise de Moraes, additional, Pedroso, Durval Ferreira Fonseca, additional, Mattos, Ederson Roberto, additional, Brito Sobrinho, Edgar de, additional, Troncoso, Edgar M. V., additional, Rodrigues Filho, Edison Moraes, additional, Nogueira, Eduardo Enrico Ferrari, additional, Ferreira, Eduardo Leme, additional, Pacheco, Eduardo Souza, additional, Jodar, Euzebio, additional, Ferreira, Evandro L. A., additional, Araujo, Fabiana Fernandes de, additional, Treviso, Fabiana Schuelter, additional, Amorim, Fábio Ferreira, additional, Giannini, Fabio Poianas, additional, Santos, Fabrício Primitivo Matos, additional, Buarque, Fátima, additional, Lima, Felipe Gallego, additional, Costa, Fernando Antonio Alvares da, additional, Sad, Fernando Cesar dos Anjos, additional, Aranha, Fernando G., additional, Ganem, Fernando, additional, Callil, Flavio, additional, Costa Filho, Francisco Flávio, additional, Dall´Arto, Frederico Toledo Campo, additional, Moreno, Geovani, additional, Friedman, Gilberto, additional, Moralez, Giulliana Martines, additional, Silva, Guilherme Abdalla da, additional, Costa, Guilherme, additional, Cavalcanti, Guilherme Silva, additional, Betônico, Gustavo Navarro, additional, Reis, Hélder, additional, Araujo, Helia Beatriz N., additional, Hortiz Júnior, Helio Anjos, additional, Guimaraes, Helio Penna, additional, Urbano, Hugo, additional, Maia, Israel, additional, Santiago Filho, Ivan Lopes, additional, Farhat Júnior, Jamil, additional, Alvarez, Janu Rangel, additional, Passos, Joel Tavares, additional, Paranhos, Jorge Eduardo da Rocha, additional, Marques, José Aurelio, additional, Moreira Filho, José Gonçalves, additional, Andrade, Jose Neto, additional, C Sobrinho, José Onofre de, additional, Bezerra, Jose Terceiro de Paiva, additional, Alves, Juliana Apolônio, additional, Ferreira, Juliana, additional, Gomes, Jussara, additional, Sato, Karina Midori, additional, Gerent, Karine, additional, Teixeira, Kathia Margarida Costa, additional, Conde, Katia Aparecida Pessoa, additional, Martins, Laércia Ferreira, additional, Figueirêdo, Lanese, additional, Rezegue, Leila, additional, Tcherniacovsk, Leonardo, additional, Ferraz, Leone Oliveira, additional, Cavalcante, Liane, additional, Rabelo, Ligia, additional, Miilher, Lilian, additional, Garcia, Lisiane, additional, Tannous, Luana, additional, Hajjar, Ludhmila Abrahão, additional, Paciência, Luís Eduardo Miranda, additional, Cruz Neto, Luiz Monteiro da, additional, Bley, Macia Valeria, additional, Sousa, Marcelo Ferreira, additional, Puga, Marcelo Lourencini, additional, Romano, Marcelo Luz Pereira, additional, Nobrega, Marciano, additional, Arbex, Marcio, additional, Rodrigues, Márcio Leite, additional, Guerreiro, Márcio Osório, additional, Rocha, Marcone, additional, Alves, Maria Angela Pangoni, additional, Rosa, Maria Doroti, additional, Dias, Mariza D’Agostino, additional, Martins, Miquéias, additional, Oliveira, Mirella de, additional, Moretti, Miriane Melo Silveira, additional, Matsui, Mirna, additional, Messender, Octavio, additional, Santarém, Orlando Luís de Andrade, additional, Silveira, Patricio Júnior Henrique da, additional, Vassallo, Paula Frizera, additional, Antoniazzi, Paulo, additional, Gottardo, Paulo César, additional, Correia, Paulo, additional, Ferreira, Paulo, additional, Torres, Paulo, additional, Silva, Pedro Gabrile M. de Barros e, additional, Foernges, Rafael, additional, Gomes, Rafael, additional, Moraes, Rafael, additional, Nonato filho, Raimundo, additional, Borba, Renato Luis, additional, Gomes, Renato V, additional, Cordioli, Ricardo, additional, Lima, Ricardo, additional, López, Ricardo Pérez, additional, Gargioni, Ricardo Rath de Oliveira, additional, Rosenblat, Richard, additional, Souza, Roberta Machado de, additional, Almeida, Roberto, additional, Narciso, Roberto Camargo, additional, Marco, Roberto, additional, waltrick, Roberto, additional, Biondi, Rodrigo, additional, Figueiredo, Rodrigo, additional, Dutra, Rodrigo Santana, additional, Batista, Roseane, additional, Felipe, Rouge, additional, Franco, Rubens Sergio da Silva, additional, Houly, Sandra, additional, Faria, Sara Socorro, additional, Pinto, Sergio Felix, additional, Luzzi, Sergio, additional, Sant’ana, Sergio, additional, Fernandes, Sergio Sonego, additional, Yamada, Sérgio, additional, Zajac, Sérgio, additional, Vaz, Sidiner Mesquita, additional, Bezerra Bezerra, Silvia Aparecida, additional, Farhat, Tatiana Bueno Tardivo, additional, Santos, Thiago Martins, additional, Smith, Tiago, additional, Silva, Ulysses V. A., additional, Damasceno, Valnei Bento, additional, Nobre, Vandack, additional, Dantas, Vicente Cés de Souza, additional, Irineu, Vivian Menezes, additional, Bogado, Viviane, additional, Nedel, Wagner, additional, Campos Filho, Walther, additional, Dantas, Weidson, additional, Viana, William, additional, Oliveira Filho, Wilson de, additional, Delgadinho, Wilson Martins, additional, Finfer, Simon, additional, and Machado, Flavia Ribeiro, additional

Published
2021
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3. Epidemiology and outcome of high-surgical-risk patients admitted to an intensive care unit in Brazil

Author

Silva Júnior, João Manoel, primary, Chaves, Renato Carneiro de Freitas, additional, Corrêa, Thiago Domingos, additional, Assunção, Murillo Santucci Cesar de, additional, Katayama, Henrique Tadashi, additional, Bosso, Fabio Eduardo, additional, Amendola, Cristina Prata, additional, Serpa Neto, Ary, additional, Malbouisson, Luiz Marcelo Sá, additional, Oliveira, Neymar Elias de, additional, Veiga, Viviane Cordeiro, additional, Rojas, Salomón Soriano Ordinola, additional, Postalli, Natalia Fioravante, additional, Alvarisa, Thais Kawagoe, additional, Lucena, Bruno Melo Nobrega de, additional, Oliveira, Raphael Augusto Gomes de, additional, Sanches, Luciana Coelho, additional, Silva, Ulysses Vasconcellos de Andrade e, additional, Nassar Junior, Antonio Paulo, additional, Réa-Neto, Álvaro, additional, Amaral, Alexandre, additional, Teles, José Mário, additional, Freitas, Flávio Geraldo Rezende de, additional, Bafi, Antônio Tonete, additional, Pacheco, Eduardo Souza, additional, Ramos, Fernando José, additional, Vieira Júnior, José Mauro, additional, Pereira, Maria Augusta Santos Rahe, additional, Schwerz, Fábio Sartori, additional, Menezes, Giovanna Padoa de, additional, Magalhães, Danielle Dourado, additional, Castro, Cristine Pilati Pileggi, additional, Henrich, Sabrina Frighetto, additional, Toledo, Diogo Oliveira, additional, Parra, Bruna Fernanda Camargo Silva, additional, Dias, Fernando Suparregui, additional, Zerman, Luiza, additional, Formolo, Fernanda, additional, Nobrega, Marciano de Sousa, additional, Piras, Claudio, additional, Piras, Stéphanie de Barros, additional, Conti, Rodrigo, additional, Bittencourt, Paulo Lisboa, additional, D’Oliveira, Ricardo Azevedo Cruz, additional, Estrela, André Ricardo de Oliveira, additional, Oliveira, Mirella Cristine de, additional, Reese, Fernanda Baeumle, additional, Motta Júnior, Jarbas da Silva, additional, Câmara, Bruna Martins Dzivielevski da, additional, David-João, Paula Geraldes, additional, Tannous, Luana Alves, additional, Chaiben, Viviane Bernardes de Oliveira, additional, Miranda, Lorena Macedo Araújo, additional, Brasil, José Arthur dos Santos, additional, Deucher, Rafael Alexandre de Oliveira, additional, Ferreira, Marcos Henrique Borges, additional, Vilela, Denner Luiz, additional, Almeida, Guilherme Cincinato de, additional, Nedel, Wagner Luis, additional, Passos, Matheus Golenia dos, additional, Marin, Luiz Gustavo, additional, Oliveira Filho, Wilson de, additional, Coutinho, Raoni Machado, additional, Oliveira, Michele Cristina Lima de, additional, Friedman, Gilberto, additional, Meregalli, André, additional, Höher, Jorge Amilton, additional, Soares, Afonso José Celente, additional, and Lobo, Suzana Margareth Ajeje, additional

Published
2020
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6. The diagnostic yield and complications of open lung biopsies in kidney transplant patients with pulmonary disease

Author

Tomotani, Daniere Yurie Vieira, primary, Bafi, Antônio Tonete, additional, Pacheco, Eduardo Souza, additional, de Sandes-Freitas, Tainá Veras, additional, Viana, Laila Almeida, additional, de Oliveira Pontes, Edgar Porto, additional, Tamura, Nikkei, additional, Tedesco-Silva Jr, Hélio, additional, Machado, Flavia Ribeiro, additional, and Freitas, Flávio Geraldo Rezende, additional

Published
2017
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7. Clinical Features of Kidney Transplant Recipients Admitted to the Intensive Care Unit

Author

Freitas, Flávio Geraldo Rezende, Lombardi, Fábio, Pacheco, Eduardo Souza, Sandes-Freitas, Tainá Veras de, Viana, Laila Almeida, Junior, Hélio Tedesco-Silva, Medina-Pestana, José Osmar, Bafi, Antônio Tonete, and Machado, Flavia Ribeiro

Abstract

Introduction: There is a paucity of data regarding the complications in kidney transplant patients who may require intensive care unit (ICU) management, despite being the most common solid organ transplant worldwide.Objective: To identify the main reasons for ICU admission and to determine the factors associated with hospital mortality in kidney transplant recipients.Design: This single-center retrospective cohort study was conducted between September 2013 and June 2014, including all consecutive kidney transplant patients requiring ICU admission. We collected data on patient demographics, transplant characteristics, clinical data, and prognostic scores. The independent determinants of hospital mortality were identified by multiple logistic regression analysis. We also assessed the performance of Simplified Acute Physiology Score 3 (SAPS 3) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores.Results: We analyzed data from 413 patients, the majority of whom were admitted late after renal transplantation (1169 days; 63-3003 days). The main reason for admission was sepsis (33.2%), followed by cardiovascular disease (16%). Age (odds ratio [OR] 1.05, confidence interval [CI], 1.01-1.09), SAPS 3 score (OR 1.04, CI, 1.01-1.08), the need for mechanical ventilation (OR 26.47, CI, 10.30-68.08), and vasopressor use (OR 3.34, CI, 1.37-8.13) were independently associated with hospital mortality. The performance of SAPS 3 and APACHE II scores was poor in this population and overestimated the mortality rates.Conclusion: Sepsis was the main reason for ICU admission in kidney transplant recipients, followed by cardiovascular disease. Age and disease severity were associated with hospital mortality.

Published
2018
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8. Epidemiologia e desfecho dos pacientes de alto risco cirúrgico admitidos em unidades de terapia intensiva no Brasil

Author

Silva Júnior,João Manoel, Chaves,Renato Carneiro de Freitas, Corrêa,Thiago Domingos, Assunção,Murillo Santucci Cesar de, Katayama,Henrique Tadashi, Bosso,Fabio Eduardo, Amendola,Cristina Prata, Serpa Neto,Ary, Malbouisson,Luiz Marcelo Sá, Oliveira,Neymar Elias de, Veiga,Viviane Cordeiro, Rojas,Salomón Soriano Ordinola, Postalli,Natalia Fioravante, Alvarisa,Thais Kawagoe, Lucena,Bruno Melo Nobrega de, Oliveira,Raphael Augusto Gomes de, Sanches,Luciana Coelho, Silva,Ulysses Vasconcellos de Andrade e, Nassar Junior,Antonio Paulo, Réa-Neto,Álvaro, Amaral,Alexandre, Teles,José Mário, Freitas,Flávio Geraldo Rezende de, Bafi,Antônio Tonete, Pacheco,Eduardo Souza, Ramos,Fernando José, Vieira Júnior,José Mauro, Pereira,Maria Augusta Santos Rahe, Schwerz,Fábio Sartori, Menezes,Giovanna Padoa de, Magalhães,Danielle Dourado, Castro,Cristine Pilati Pileggi, Henrich,Sabrina Frighetto, Toledo,Diogo Oliveira, Parra,Bruna Fernanda Camargo Silva, Dias,Fernando Suparregui, Zerman,Luiza, Formolo,Fernanda, Nobrega,Marciano de Sousa, Piras,Claudio, Piras,Stéphanie de Barros, Conti,Rodrigo, Bittencourt,Paulo Lisboa, D’Oliveira,Ricardo Azevedo Cruz, Estrela,André Ricardo de Oliveira, Oliveira,Mirella Cristine de, Reese,Fernanda Baeumle, Motta Júnior,Jarbas da Silva, Câmara,Bruna Martins Dzivielevski da, David-João,Paula Geraldes, Tannous,Luana Alves, Chaiben,Viviane Bernardes de Oliveira, Miranda,Lorena Macedo Araújo, Brasil,José Arthur dos Santos, Deucher,Rafael Alexandre de Oliveira, Ferreira,Marcos Henrique Borges, Vilela,Denner Luiz, Almeida,Guilherme Cincinato de, Nedel,Wagner Luis, Passos,Matheus Golenia dos, Marin,Luiz Gustavo, Oliveira Filho,Wilson de, Coutinho,Raoni Machado, Oliveira,Michele Cristina Lima de, Friedman,Gilberto, Meregalli,André, Höher,Jorge Amilton, Soares,Afonso José Celente, and Lobo,Suzana Margareth Ajeje

Subjects
Procedimentos cirúrgicos operatórios/mortalidade, Cuidados pós-operatórios, Unidades de terapia intensiva, RC86-88.9, Brasil, Procedimentos cirúrgicos operatórios/ epidemiologia, Complicações pós-operatórias/mortalidade, Medical emergencies. Critical care. Intensive care. First aid
Abstract

RESUMO Objetivo: Definir o perfil epidemiológico e os principais determinantes de morbimortalidade dos pacientes cirúrgicos não cardíacos de alto risco no Brasil. Métodos: Estudo prospectivo, observacional e multicêntrico. Todos os pacientes cirúrgicos não cardíacos admitidos nas unidades de terapia intensiva, ou seja, considerados de alto risco, no período de 1 mês, foram avaliados e acompanhados diariamente por, no máximo, 7 dias na unidade de terapia intensiva, para determinação de complicações. As taxas de mortalidade em 28 dias de pós-operatório, na unidade de terapia intensiva e hospitalar foram avaliadas. Resultados: Participaram 29 unidades de terapia intensiva onde foram realizadas cirurgias em 25.500 pacientes, dos quais 904 (3,5%) de alto risco (intervalo de confiança de 95% - IC95% 3,3% - 3,8%), tendo sido incluídos no estudo. Dos pacientes envolvidos, 48,3% eram de unidades de terapia intensiva privadas e 51,7% de públicas. O tempo de internação na unidade de terapia intensiva foi de 2,0 (1,0 - 4,0) dias e hospitalar de 9,5 (5,4 - 18,6) dias. As taxas de complicações foram 29,9% (IC95% 26,4 - 33,7) e mortalidade em 28 dias pós-cirurgia 9,6% (IC95% 7,4 - 12,1). Os fatores independentes de risco para complicações foram Simplified Acute Physiology Score 3 (SAPS 3; razão de chance − RC = 1,02; IC95% 1,01 - 1,03) e Sequential Organ Failure Assessment Score (SOFA) da admissão na unidade de terapia intensiva (RC =1,17; IC95% 1,09 - 1,25), tempo de cirurgia (RC = 1,001; IC95% 1,000 - 1,002) e cirurgias de emergências (RC = 1,93; IC95% 1,10 - 3,38). Em adição, foram associados com mortalidade em 28 dias idade (RC = 1,032; IC95% 1,011 - 1,052) SAPS 3 (RC = 1,041; IC95% 1,107 - 1,279), SOFA (RC = 1,175; IC95% 1,069 - 1,292) e cirurgias emergenciais (RC = 2,509; IC95% 1,040 - 6,051). Conclusão: Pacientes com escores prognósticos mais elevados, idosos, tempo cirúrgico e cirurgias emergenciais estiveram fortemente associados a maior mortalidade em 28 dias e mais complicações durante permanência em unidade de terapia intensiva.

9. [Effects of the positive end-expiratory pressure increase on sublingual microcirculation in patients with acute respiratory distress syndrome].

Author

Nunes NF, Bafi AT, Pacheco ES, Azevedo LCP, Machado FR, and Freitas FGR

Subjects
Aged, Female, Humans, Male, Middle Aged, Microcirculation, Mouth Floor blood supply, Positive-Pressure Respiration, Respiratory Distress Syndrome physiopathology, Respiratory Distress Syndrome therapy
Abstract

Objective: The aim of this study was to evaluate the impact of increased positive end-expiratory pressure on the sublingual microcirculation., Methods: Adult patients who were sedated, under mechanical ventilation, and had a diagnosis of circulatory shock and acute respiratory distress syndrome were included. The positive end-expiratory pressure level was settled to obtain a plateau pressure of 30cmH 2 O and then maintained at this level for 20minutes. Microcirculatory (obtained by videomicroscopy) and hemodynamic variables were collected at baseline and compared with those at the end of 20min., Results: Twelve patients were enrolled. Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, there was considerable interindividual variability. There was a negative, moderate correlation between the changes in the De Backer score (r=-0.58, p=0.048), total vessel density (r=-0.60, p=0.039) and baseline values. The changes in total vessel density (r=0.54, p=0.07) and perfused vessel density (r=0.52, p=0.08) trended toward correlating with the changes in the mean arterial pressure., Conclusion: Overall, the microcirculation parameters did not significantly change after increasing the positive end-expiratory pressure. However, at individual level, such response was heterogeneous. The changes in the microcirculation parameters could be correlated with the baseline values and changes in the mean arterial pressure., (Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Published
2017
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