Pressões inspiratórias como preditores de sucesso na extubação em prematuros de muito peso

Pós-graduação em Pediatria - FMB

Efeitos da dexmedetomidina nas respostas cardiovascular e de oxigenação sistêmica ao pinçamento aórtico infra-renal em cães sob anestesia com sevoflurano

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo da proteção renal com antioxidante durante isquemia e reperfusão e hiperglicemia transitória

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Inter-relações entre zooplâncton e fitoplâncton mediante herbivoria na Lagoa do Camargo (zona de desembocadura do Rio Paranapanema na Represa de Jurumirim)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Infusão contínua de morfina ou fentanil, associados à lidocaína e cetamina, em cães anestesiados com isofluorano

A técnica de analgesia multimodal, por meio da infusão contínua de fármacos, pode ser empregada para diminuir a incidência de sensibilização central durante a anestesia. Avaliaram-se as características cardiorrespiratórias, durante o procedimento de artroscopia de joelho, em cães anestesiados com isofluorano e monitorados por meio do índice biespectral, submetidos à infusão contínua de morfina ou fentanil, associada à lidocaína e cetamina. Utilizaram-se 16 cães adultos, machos ou fêmeas, os quais foram distribuídos aleatoriamente em dois grupos, denominados MLK - que recebeu morfina (3,3μg/kg/min), lidocaína (50μg/kg/min) e cetamina (10μg/kg/min) ou FLK - em que foi substituída a morfina pelo fentanil (0,03μg/kg/min). Os cães foram pré-tratados com levomepromazina (0,5mg/kg IV), induzidos à anestesia com propofol (5mg/kg) e mantidos com isofluorano, ajustando-se a concentração para obterem-se valores de índice biespectral entre 55 e 65. As mensurações da frequência cardíaca (FC), dos parâmetros eletrocardiográficos (ECG), das pressões arteriais sistólica (PAS), diastólica (PAD) e média (PAM), da tensão de dióxido de carbono expirado (EtCO2), da saturação de oxi-hemoglobina (SpO2), da frequência respiratória (FR) e da temperatura esofágica (T) iniciaram-se 30 minutos após a indução (M0) e continuaram após o início da infusão das soluções, em intervalos de 15 minutos (M15 a M75). Diferenças entre os grupos foram registradas para duração do complexo QRS (M60), para FC e T, entre M30 e M75, com MLK apresentando médias maiores que FLK, que registrou médias maiores que MLK para a SpO2 (M60), para os intervalos QT (M30 e M75) e RR (M0, M60 e M75). Concluiu-se que o emprego de morfina ou fentanil, associados à lidocaína e cetamina, promove efeitos semelhantes e não compromete as características avaliadas.

Efeitos da higienização brônquica nas variáveis cardiorrespiratórias de pacientes em ventilação mecânica

INTRODUCTION: During mechanical ventilation (MV), the airways may accumulate secretions. Patients are submitted to Respiratory Therapy (RT) and tracheal aspiration when in MV, alone or associated, to eliminate these secretions. OBJECTIVE: The objective was to compare the effects of different protocols of bronchial hygiene in blood pressure, heart rate, oxygen saturation and respiratory rate of patients undergoing MV. MATERIALS AND METHODS: We conducted a prospective, randomized, controlled crossover, with intentional non-probabilistic sample in the Medical School Hospital of Marília. We included patients in invasive MV who were submitted to three different bronchial hygiene protocols: PP - physiotherapy protocol (manual chest compression and manual hyperinflation); AP - aspiration protocol; and PP + AP. Respiratory rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation and heart rate were evaluated in three moments: before (M1), immediately after (M2) and 30 minutes after (M3) for each protocol. The differences among protocols and times were assessed using ANOVA and post hoc Student Newman-Keus (p < 0.05). RESULTS: We studied eighteen 71.2 ± 13.9 year-old patients with 15.1 ± 17.7 days of MV. There were no differences among protocols. There was a significant decreasing in SBP (p = 0.0261) and DBP (p = 0.0119) from M2 to M3 in the aspiration protocol. CONCLUSION: There was a decrease of blood pressure on MV patients after 30 minutes of aspiration and no change in the other variables, and there was no difference among protocols.

Microhabitat de Tolypothrix distorta Kütz. ex Bornet & Flahault (Microchaetaceae, Cyanophyta) em dois riachos da região Centro-Sul do Estado do Paraná, Brasil

This study aimed to evaluate some microhabitat characteristics of two populations of Tolypothrix distorta in streams from midsouthern region of Paraná State on a seasonal period. Each population was monthly investigated for the abundance of T. distorta and environmental variables such as depth, current velocity, irradiance, richness, and substrate diversity (H') using the quadrat technique for each sample unit (n = 7-10). For each segment the following physical and chemical water variables were also measured: temperature, oxygen saturation, specific conductance, pH, and turbidity. The seasonal period of higher abundance (percent cover) occurred during the months corresponding to summer/fall for both populations. The analyses also showed that populations had lower niche width and wide variation under the environmental conditions, characterizing the species as a generalist in the use of resources. Faster water flow and larger substrates favored the development of T. distorta, which may be related to the species morphological characteristics, thallus type that consists of tangled filaments formed by tuft and covered with thick gelatinous coats.

The effect of sets and repetitions of the spirometer by flow in cardiorespiratory parameters

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influência do estímulo verbal no tempo do teste de escada

Introduction: The stair-climbing test (SCT) is considered a submaximal test of simple implementation and easy access, which assesses the individual’s functional capacity. Although widely used in surgical patients, there is no standardization regarding the height of the stair and verbal stimulus. Objectives: It was determine if verbal stimulus changes the stair-climbing time (SCt) in individuals over 50 years-old. We compared oxygenation, blood pressure, pulse, respiratory rate and Borg scale between SCT performed with and without stimulation. Methods: We evaluated individuals with ages greater than 50 years-old that performed two STC (with and without verbal stimulation), in the stair with 44 steps, achieving 7.04 m in height and recording the time to climb the stair. The systolic blood pressure (SBP) and the diastolic blood pressure (DBP), respiratory rate (RR), pulse, oxygen saturation (SpO2 ) and Borg scale were evaluated before and after the tests. The time in the SCT with and without stimulation were compared using the Student test-t and the other variables were compared using the ANOVA test (p<0.05). Results: The average age was 59.75±6,40 years old in the 21 evaluated individuals. The time in the SCT without stimulus was significantly higher than the one with stimulus. The SBP, pulse, RR and Borg scale were significantly increased when compared to the SCT with and without stimulus. Oxygenation and DBP didn´t have significant differences at any time of the study. Conclusions: The time in the SCT was lower when performed with verbal stimulus. The SBP, pulse, RR and Borg scale changed significantly after the SCT with and without stimulus, remarking that this change was greater in the SCT with stimulus.

Comparação das variáveis hemodinâmicas durante o teste de caminhada de seis minutos e o teste de escada em adultos saudáveis

The effort test can be used to assess functional capacity, clinical hemodynamic and metabolic response at the effort, the risk of postoperative pulmonary complications and to assess the response of patients with lung diseases submitted to physiotherapy treatment. Among the stress tests we highlight the Six Minute Test Walk (6 MWT) and Stair Climbing Test (SCT), because they are easy to use and low cost. Especially the SCT is widely used in patients preoperatively. Objective: To compare the effects of six minute walk test and stair climbing test under the hemodynamic and oxygenation in healthy adults. Methods: We conducted a study with healthy subjects above 50 years. The fi rst performed was 6 MWT in quick step with encouragement, in a plan corridor of 30 meters, where the shade was determined the distance walked in 6 minutes, after 6 MWT was performed de SCT with encouragement, on a ladder in shade, consists of 44 steps, with 4 bids and bid by 11 steps, each step measured 16 cm in a total of 7.04 m of height, where the rise time was clocked. Before and after the two tests were measured respiratory rate, pulse, blood pressure and oxygen saturation. Results: We evaluated 21 patients with age 59.6 ± 5.4 years, 5 men and 16 women. The average distance covered on the 6MWT was 496.4 ± 102.2 meters and the average time in SCT 22.6 ± 5.4 seconds. The variables pulse, respiratory rate, systolic blood pressure and Borg scale presented a signifi - cant increase after the tests, however the variables oxygen saturation and diastolic blood pressure did not change signifi cantly. Conclusion: The variables pulse, respiratory rate, systolic blood pressure and Borg scale tests increased after six-minute walk test and stair climbing test but with greater signifi cance after the stair climbing test. Oxygen saturation and diastolic blood pressure did not change signifi cantly after the tests.

Evaluation of physiological parameters before and after respiratory physiotherapy in newborns with acute viral bronchiolitis

Background: Acute viral bronchiolitis is a respiratory disease with high morbidity that affects newborn in the first two years of life. Its treatment with physiotherapy has been highlighted as an important tool, however, there is no consensus regarding its effects on patients improvement. We aimed to evaluate the physiological parameters before and after the procedure respiratory therapy in newborn with acute viral bronchiolitis. Method: This was a cross sectional observational study in 30 newborns with acute viral bronchiolitis and indicated for physiotherapy care in a hospitalized Urgency and Emergency Unit. It was collected the clinical data of newborn through evaluation form, and we measured heart rate (HR), oxygen saturation (SpO2) and respiratory rate (RR). We measured the variables before physiotherapy treatment, 3, 6 and 9 minutes after the physiotherapy treatment. Results: There has been no change in HR, however, we observed a decrease in RR at 6 and 9 min compared to 3 min and increase in SpO2 at 3, 6 and 9 min compared to before physiotherapy. Conclusion: Respiratory physiotherapy may be an effective therapy for the treatment of newborn with Acute Viral Bronchitis.

Variação sazonal das variáveis físicas e químicas em riachos de duas bacias da região centro-sul do estado do Paraná, sul do Brasil

The present study was developed in two streams from the two different drainage basins located in the mid-southern region of Paraná state. In each stream were evaluated some physical and chemical parameters in open (without streamside vegetation) and shaded (with streamside vegetation) segments. Monthly samplings were carried out from January to December 2007. The following limnological parameters were measured: water temperature, specific conductance, oxygen saturation, pH, turbidity and current velocity. In the same stream were not observed differences among segments from the drainage basins, and nominal values and seasonal pattern have been very similar between open and shaded ambient. A Principal Component Analysis (PCA) showed small divergence between streams and segments, with separation of groups with base sampling dates. The results suggest that the region is homogeneous according to physical and chemical water conditions, therefore, stronger influenced for time factor, and diverging seasonal periods associated a climatic region condition.

Estudo comparativo de parâmetros limnológicos de duas bacias de drenagem da região centro-sul do Estado do Paraná, sul do Brasil

Two drainage basins located in the mid-southern region of Paraná state were comparatively studied for analysis of limnological characteristics in lotic ecosystems. Ten segments of rivers and streams were evaluated in each basin, from June 4th through to June, 29th , 2007. The following physical and chemical parameters were measured: water temperature, specific conductance, oxygen saturation, pH, turbidity, current velocity and depth. The two drainage basins presented similar nominal values for all parameters investigated. There were significant differences between the two environments in relation to temperature, pH, and oxygen saturation. Cluster analysis revealed five small groups of samplings, each one with particular limnological characteristics. The Principal Components Analysis (PCA) confirmed the difference among the drainage basins. These results suggest an influence of regional and local factors in limnological characteristics of rivers and streams in the studied drainage basins.

Effects of a dexmedetomidine constant rate infusion and atropine on changes in global perfusion variables induced by hemorrhage followed by volume replacement in isoflurane-anesthetized dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of ophthalmic and hemodynamic parameters in capuchin monkeys (Sapajus sp.) submitted to dissociative anesthetic protocols

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)