Corona virus disease 2019 lesion segmentation network based on an adaptive joint loss function / 生物医学工程学杂志

Corona virus disease 2019 (COVID-19) is an acute respiratory infectious disease with strong contagiousness, strong variability, and long incubation period. The probability of misdiagnosis and missed diagnosis can be significantly decreased with the use of automatic segmentation of COVID-19 lesions based on computed tomography images, which helps doctors in rapid diagnosis and precise treatment. This paper introduced the level set generalized Dice loss function (LGDL) in conjunction with the level set segmentation method based on COVID-19 lesion segmentation network and proposed a dual-path COVID-19 lesion segmentation network (Dual-SAUNet++) to address the pain points such as the complex symptoms of COVID-19 and the blurred boundaries that are challenging to segment. LGDL is an adaptive weight joint loss obtained by combining the generalized Dice loss of the mask path and the mean square error of the level set path. On the test set, the model achieved Dice similarity coefficient of (87.81 ± 10.86)%, intersection over union of (79.20 ± 14.58)%, sensitivity of (94.18 ± 13.56)%, specificity of (99.83 ± 0.43)% and Hausdorff distance of 18.29 ± 31.48 mm. Studies indicated that Dual-SAUNet++ has a great anti-noise capability and it can segment multi-scale lesions while simultaneously focusing on their area and border information. The method proposed in this paper assists doctors in judging the severity of COVID-19 infection by accurately segmenting the lesion, and provides a reliable basis for subsequent clinical treatment.

¿Polipnea o taquipnea? Esa es la cuestión / Compliance with the recommendations for physical activity set by the WHO by public bicycle users in a Spanish municipality

RESUMEN Introducción: Polipnea y taquipnea tienen significados diferentes en diversos textos y los estudiantes de Medicina se desorientan al estudiar la Semiología de la disnea. Objetivo: Elucidar la disparidad semántica entre polipnea y taquipnea. Material y Métodos: Se realizó una revisión bibliográfica utilizando los descriptores en ciencias de la salud taquipnea y polipnea. Se realizó una búsqueda en quince textos de Semiología Médica y en otros libros y revistas, impresos y electrónicos, entre ellos, la Revista Española de Cardiología (enero 1997 a diciembre 2020) en Archivos de Bronconeumología(diciembre 1964 a diciembre 2020); y se hizo el análisis etimológico de las palabras estudiadas, en Medigraphic (2012-21). Resultados: Seis de quince textos de Semiología consideran sinónimos polipnea y taquipnea; cuatro, solo emplean polipnea; y dos, taquipnea. Tres distinguen taquipnea como aumento de la frecuencia respiratoria; de polipnea, respiración superficial y rápida; dos definen taquipnea como aumento de la frecuencia respiratoria simple o con disminución de la amplitud (respiración superficial) y polipnea o hiperpnea, como aumento de la profundidad respiratoria con incremento de la frecuencia. En revistas científicas, taquipnea apareció en 192 artículos como respiración rápida y superficial; con igual significado se encontró polipnea, en 27. Según origen, taquipnea significa aceleración del ritmo respiratorio; polipnea, respiración muy frecuente y superficial, sin relación con polýpnóoos: "que sopla con fuerza" e hiperpnea significa incremento de la velocidad y amplitud de los movimientos respiratorios. Conclusiones: Polipnea y taquipnea deben considerarse equivalentes de respiración rápida y superficial; taquipnea simple, si la amplitud respiratoria es normal; e hiperpnea denomina la respiración muy frecuente y profunda.

ABSTRACT Introduction: Polypnea and tachypnea have different meanings in several texts, and medical studentsmay get confusedwith just the study of the semiology of dyspnea. Objective: Toelucidatethe semantic gap between polypnea and tachypnea. Material and Methods: A bibliographic review was conducted usinghealth science descriptors such as tachypnea and polypnea; a search was performed in 15 texts of Medical Semiology and other printed or electronic books and journals, among them, theRevista Española de Cardiología(fromJanuary 1997 to December 2020) andArchivos de Bronconeumología (from December 1964 toDecember 2020); in addition, the etymological analysis of these words was carried out in Medigraphic (2012-2021). Results: Six out of fifteen texts on semiology consider that the termspolypnea and tachypnea are synonymous; fourtexts only use polypnea; and two use the term tachypnea. Three texts distinguish tachypnea as increased respiratory rate, andpolypnea as arapid, shallow breathing; two texts define tachypnea as a simple increase in the respiratory rateor a decrease in the respiratory amplitude (shallow breathing); and polypnea or hyperpnea as the increasein depth and rate of breathing.In scientific journals, the term tachypnea was usedin 192 papersto refer to rapid, shallow breathing; andpolypnea had the same meaning in 27 articles. According to its origin, tachypnea means rapid respiratory rate; Polypnea is presented as very frequent and shallow breathing, unrelated to polýpnoos: "that blows forcefully"; while hyperpneameans an increase in the speed and amplitude of respiratory movements. Conclusions: Polypnea and tachypnea should be considered as equivalents of rapid andshallow breathing; simple tachypneaif the respiratory amplitude is normal; and hyperpnea designs a very frequent and deep breathing.

Índice de respiración rápida superficial diafragmática como predictor weaning de la ventilación mecánica / Rate of rapid superficial diaphragmatic breathing as a weaning predictor of mechanical ventilation

El destete de la ventilación mecánica (VM) es un paso clave para los pacientes sometidos a VM invasiva en la unidad de cuidados intensivos (UCI). Entre las diversas herramientas destinadas a ayudar a predecir el fracaso sucesor del destete, encontramos el índice rápido de respiración superficial (RSBI por sus siglas en inglés), es decir, la relación entre la frecuencia respiratoria y el volumen corriente (Fr/Vt) medido durante una prueba de respiración espontánea (SBT por sus siglas en inglés). Objetivo: Describir el índice de respiración superficial diagramática como predictor Weaning de la ventilación mecánica. Materiales y métodos: Estudio de revisión, de tipo monográfico. Apoyado en artículos científicos, publicados en diferentes revistas indexzada en índices reconocidos. Resultado: Durante un SBT, el valor de RSBI parece ser paralelo a la evolución de la fatiga de los músculos respiratorios. Por lo tanto, se considera que el RSBI refleja la carga inspiratoria, siendo la disminución del volumen tidal junto con el aumento de frecuencia respiratoria indicativo de posible debilidad o fatiga de los músculos inspiratorios, u otros efectos fisiológicos. Conclusión: Entre los pacientes ventilados en la UCI, una alteración multifactorial del diafragma es común y puede resultar en falla del destete y prolongación de la VM invasiva; por lo tanto, evaluar la función del diafragma es un medio útil para evaluar la capacidad del paciente para tolerar la respiración espontánea(AU)

Weaning from mechanical ventilation (MV) is a key step for patients undergoing invasive MV in the intensive care unit (ICU). Among the various tools intended to help predict successor failure weaning, we found the rapid shallow breathing index (RSBI for its acronym in English), that is, the relationship between the respiratory rate and the volume current (Fr/Vt) measured during a spontaneous breathing test (SBT by its acronym in English). Objective: To describe the rate of shallow breathing Diagrammatic as a Weaning predictor of mechanical ventilation. Materials and methods: Review study, monographic type. supported by articles scientific, published in different magazines indexed in recognized indices. Result: During an SBT, the RSBI value appears to be parallel to the evolution of respiratory muscle fatigue. Therefore, it is considered that the RSBI reflects the inspiratory load, being the decrease in tidal volume together with the increased respiratory rate indicative of possible weakness or fatigue of the inspiratory muscles, or other physiological effects. Conclusion: Among the patients ventilated in the ICU, a multifactorial alteration of the diaphragm is common and can result in weaning failure and prolongation of invasive MV; by Therefore, assessing diaphragm function is a useful means of assessing the patient's ability to tolerate spontaneous breathing(AU)

Behavior of clinical and humoral variables on admission as predictors of death in patients with community-acquired pneumonia. Comparative study between adults and older adults. / Comportamiento de variables clínicas y humorales al ingreso, como predictores de fallecimiento en pacientes con neumonía adquirida en la comunidad. Estudio comparativo entre adultos y adultos mayores

Community-acquired pneumonia is recognized as one of the main infectious health problems worldwide. The objective was to determine the condition of predictors of death for a group of selected clinical conditions, and for laboratory variables frequently used in practice. Study with descriptive design, which included 967 patients with pneumonia hospitalized between 2016 and 2019, and whose information was obtained from clinical records. Statistical treatment included bivariate and multivariate analysis (logistic regression); it was used the ratio of crossed products (odds ratio) and its 95% confidence interval. Several manifestations were significantly more frequent in older adults: dyspnea (OR 1.5[1.07,2.1]), absence of productive cough (OR 1.7 [1.3, 2.4]), neuropsychological manifestations (OR 2 [1.4,2.8]), tachypnea (OR 1.5 [1.1,2.1]), arterial hypotension (OR 2.1 [1.2,3.6]), anemia (OR 1.6[1.2,2.2]), elevated creatinine (OR 1.6[1.2,2.3]) and hypoproteinemia (OR 3.3[1.9,5.7]); showed a significant association with death: absence of productive cough, neuropsychological manifestations, temperature below 36 degrees Celsius, blood pressure below 110/70 mmHg, respiratory rate above 20 per minute, hemoglobin below 100 g/L, erythrosedimentation greater than 20 mm/L, leukopenia less than 5 x 109/L and serum creatinine above 130 micromol/L. As conclusions certain clinical and laboratory conditions present in the patient at the time of hospital admission, of routine exploration in the comprehensive assessment of the patient, were predictors of death. Additionally, the existence of evident differences in the number of conditions with a predictive nature of death between the population with pneumonia under 60 years of age and the elderly, as well as in the frequency of these conditions in both subgroups, is verified.

La neumonía adquirida en la comunidad está reconocida como uno de los principales problemas de salud de tipo infeccioso al nivel mundial. La investigación tuvo como objetivo determinar el carácter de predictores de fallecimiento de un grupo de condiciones clínicas seleccionadas, y de variables de laboratorio de uso frecuente en la práctica. Se realizó un estudio con diseño descriptivo, que incluyó a 967 pacientes con neumonía hospitalizados entre 2016 y 2019, y cuya información se obtuvo de los expedientes clínicos. El tratamiento estadístico incluyó análisis bivariante y multivariado (regresión logística); como estadígrafo se utilizó la razón de productos cruzados (odds ratio) y su intervalo de confianza de 95%. Entre los resultados se destacan los siguientes: varias manifestaciones fueron significativamente más frecuentes en los adultos mayores: disnea (OR 1,5[1,07;2,1]), ausencia de tos productiva (OR 1,7[1,3;2,4]), manifestaciones neuropsicológicas (OR 2[1,4;2,8]), taquipnea (OR 1,5[1,1;2,1]), hipotensión arterial (OR 2,1[1,2;3,6]), anemia (OR 1,6[1,2;2,2]), creatinina elevada (OR 1,6[1,2;2,3]) e hipoproteinemia (OR 3,3[1,9;5,7]); mostraron asociación significativa con el fallecimiento: ausencia de tos productiva, manifestaciones neuropsicológicas, temperatura por debajo de 36 grados Celsius, tensión arterial inferior a 110/70 mmHg, frecuencia respiratoria por encima de 20 por minuto, hemoglobina inferior a 100 g/L, velocidad de sedimentación eritrocitaria superior a 20 mm/L, leucopenia inferior a 5 x 109/L y creatinina sérica por encima de 130 micromol/L. Se concluye que ciertas condiciones clínicas y de laboratorio presentes en el paciente al momento del ingreso hospitalario, de exploración habitual en la valoración integral del enfermo, constituyeron predictores de fallecimiento. Adicionalmente, se comprueba la existencia de evidentes diferencias en el número de condiciones con carácter predictor de muerte entre la población con neumonía menor de 60 años y los adultos mayores, así como en la frecuencia de estas condiciones en ambos subgrupos.

Adaptation and acceptability testing of the Expector® vibration vest in horses / Adaptação e teste de aceitabilidade do colete de vibração Expector® em equinos

The project is based on a test of a thoracic vibration vest prototype, adapted to equines by the Expector® vest's company, on healthy animals. Ten (10) equines were used in the project, male or female, adults, healthy, belonging to FMVZ-USP or private owners. Each animal went through two phases: A and B. Phase A consisted of the placement of the vest without turning on the vibrators, evaluating the animal's acceptability, facility, adaptation to the animal's body, and discomfort due to the vest's use. Phase B included the placement of the vest and turning on the vibrators, evaluating the animal's acceptability, reaction to the vibrators, and, if present, to which velocity/type of vibration, and the presence of adverse effects. Both phases were done three times on separate days. The behavioral parameters: "placement facility" and "adaptation to the animal's body" were observed. In phase B, the response to the vibration was classified from 0 to 5. The answer was evaluated on low and high intensities for the four vibration types. The heart rate (HR) and respiratory rate (RR) were also evaluated at the beginning and end of each repetition. The animals' HR was kept on normal, except for one animal on one day of the test. Concerning the RR, most animals presented moments of tachypnea. On the experiment's first day, 100% of grade Great to "facility of placement" and "adaptation to the animal's body" was obtained, but on days 2 and 3 this value dropped to 90% due to alterations in one animal's responses. Regarding vibration's responses, 77.3% were evaluated as no discomfort (grade 0), 17.1% little discomfort (grade 1), 3.3% medium discomfort (grade 2), 0.4% great discomfort (grade 3), 0.21% extreme discomfort (grade 4), and 1.6% non-acceptance of the vest (grade 5). Some possible changes on the prototype were also verified to be suggested to the manufacturer, such as the change of the buckle and the use of wireless control. Vest use appears promising for equine respiratory physiotherapy, considering the acceptability was good, and its efficiency on the expectoration of diseased animals must be tested.

O projeto consistiu no teste de um protótipo de colete de vibração torácica, adaptado aos equinos pela empresa do colete Expector®, em animais saudáveis. Foram utilizados 10 equinos, machos ou fêmeas, adultos, saudáveis, pertencentes à FMVZ-USP e a proprietários particulares. Cada animal passou por duas fases: A e B. A Fase A consistiu na colocação do colete sem ligar os vibradores, avaliando-se a aceitabilidade do animal; facilidade; adaptação ao corpo do animal e incômodo do mesmo à sua presença. Já a Fase B contava com a colocação do colete e funcionamento dos vibradores, avaliando-se a aceitabilidade do animal; reação aos vibradores e, se presente, a qual velocidade/tipo de vibração; presença de reações ou efeitos adversos. As duas fases foram realizadas em triplicata em dias separados. Foram observados os parâmetros comportamentais "facilidade de colocação" e "adaptação ao corpo do animal". Na fase B, a resposta à vibração foi classificada de 0 a 5. A resposta foi avaliada nas intensidades baixa e alta para os quatro diferentes tipos de vibração. Foram avaliadas também as frequências cardíaca (FC) e respiratória (FR) no início e final de cada repetição. A FC dos animais se manteve dentro do intervalo de normalidade, com exceção de um animal em um dia de avaliação. Em relação à FR, a maioria apresentou momentos de taquipneia. No primeiro dia de experimento obteve-se 100% de avaliação Ótima para "facilidade de colocação" e "adaptação ao corpo do animal", mas nos dias 2 e 3 esse valor caiu para 90% devido à alteração na resposta de um animal. Em relação à resposta à vibração, 77,3% das respostas foram avaliadas como nenhum incômodo (nota 0), 17,1% pouco incômodo (nota 1), 3,3% médio incômodo (nota 2), 0,4% muito incômodo (nota 3), 0,21% incômodo extremo (nota 4) e 1,6% não aceitação do colete (nota 5). Foram também verificadas algumas possíveis mudanças no protótipo a serem sugeridas ao fabricante, como mudança do tipo de fivela e uso de controle sem fio. A utilização do colete parece ser muito promissora para a fisioterapia respiratória em equinos, visto que a aceitabilidade foi muito boa, devendo-se agora realizar a avaliação de sua eficácia na expectoração de animais enfermos.(AU)

Pressão positiva expiratória das vias aéreas sobre a oxigenação e hemodinâmica em pacientes submetidos a revascularização do miocárdio / Expiratory positive airway pressure on oxygenation and hemodynamics in patients submitted to coronary artery bypass grafting

)Introdução: A pressão positiva expiratória nas vias aéreas (EPAP) é a aplicação de uma resistência expiratória para manter a pressão positiva nas vias aéreas e também tem sido amplamente utilizada para prevenir possíveis complicações no pós-operatório de cirurgia cardíaca. Objetivo: Descrever o comportamento da oxigenação e hemodinâmica durante o uso de EPAP em pacientes submetidos à cirurgia de revascularização do miocárdio (RM). Métodos: Estudo transversal que avaliou saturação periférica de oxigênio (SpO2), frequência cardíaca (FC), frequência respiratória (FR), pressão arterial sistólica (PAS), diastólica (PAD) e média (PAM), pressão arterial de oxigênio (PaO2), pressão arterial de dióxido de carbono (PaCO2) e índice de oxigenação calculado dividindo a PaO2 pela fração inspirada de oxigênio (FiO2), os pacientes foram avaliados em repouso, no primeiro dia de pós-operatório. A EPAP foi realizada com o paciente em sedestação na poltrona e uma gasometria arterial foi coletada e analisada para verificar os valores de PaO2, PaCO2, SaO2 e PaO2/FiO2. Foi aplicada uma resistência expiratória de 12 cmH2O por dez minutos. Imediatamente após a aplicação do EPAP, os pacientes tiveram nova análise gasométrica e a hemodinâmica analisada. Resultados: 58 pacientes, 41 (71%) do sexo masculino e com idade média de 54 ± 8 anos foram avaliados. O uso de EPAP no pós-operatório levou à melhora de todas as variáveis gasométricas, exceto PaCO2. Houve uma melhora na SaO2 (%) pré-EPAP 94 ± 3 e pós-EPAP 98 ± 2, PaO2/FiO2 pré-EPAP 279 ± 10 e pós-EPAP 346 ± 8, PaO2 (mmHg) pré-EPAP 78 ± 8 e pós-EPAP 97 ± 7. Conclusão: Concluiu-se que a aplicação do EPAP teve um impacto positivo na oxigenação em pacientes submetidos à RM sem gerar efeitos adversos na hemodinâmica. (AU)

Development of Respiratory Signal Monitoring System Based on Photoplethysmography / 中国医疗器械杂志

Breathing is of great significance in the monitoring of patients with obstructive sleep apnea hypopnea syndrome, perioperative monitoring and intensive care. In this study, a respiratory monitoring and verification system based on optical capacitance product pulse wave (PPG) is designed, which can synchronously collect human PPG signals. Through algorithm processing, the characteristic parameters of PPG signal are calculated, and the respiratory signal and respiratory frequency can be extracted in real time. In order to verify the accuracy of extracting respiratory signal and respiratory rate by the algorithm, the system adds the nasal airflow respiratory signal acquisition module to synchronously collect the nasal airflow respiratory signal as the standard signal for comparison and verification. Finally, the root mean square error between the respiratory rate extracted by the algorithm from the pulse wave and the standard respiratory rate is only 1.05 times/min.

Relationship between motor-cognitive functions and hemodynamic response of individuals with chronic stroke during and after an acute bout of aerobic exercise / Relação entre as funções motoras cognitivas e a resposta hemodinâmica de indivíduos com AVC crônico durante e após uma sessão aguda de exercícios aeróbicos

BACKGROUNG: Individuals post-stroke commonly presents functional and cardiorespiratory deficits besides a physical inactivity lifestyle in the chronic phase of disease. Considering this, there is a hypothesis that hemodynamic responses could be affected by motor, cognitive and cardiorespiratory deficits during the aerobic exercise. In order to identify functional conditions that can influence the aerobic performance of these individuals, correlations between functional variables and hemodynamic responses during and after the aerobic exercise were studied. As a secondary purpose, the ability of return to hemodynamic resting state were also analyzedMETHODS: In this experimental study, after being evaluated about their motor and cognitive function, balance and prognosis, forty participants underwent a 30-minute aerobic exercise session on a treadmill. Training heart rate, arterial blood pressure, oxygen pulse saturation, heart rate, and respiratory rate were measured before begin the exercise session, every five minutes during the exercise and five minutes after itRESULTS: Cardiorespiratory parameters within normality limits in all phases of the exercise and the capacity of returning to the resting state were observed. Moderate inverse correlations were found between Berg Scale and oxygen pulse saturation (r =-0.401, p = 0.01), between MMSE and diastolic blood pressure (r = -0.406, p = 0.009), age and diastolic blood pressure (r = -0.435, p = 0.005) and between injury time and RR (r = -0.454, p = 0.003). Relationship between the lesion side and the 20 minutes phase of aerobic exercise was also observed (p = 0.042CONCLUSION: Post- stroke individuals present moderate correlation between hemodynamic and respiratory responses during aerobic exercise and balance, muscle strength, injury time, age and side of lesion. They also have the capacity to return to their cardiorespiratory and cardiovascular resting state right after the activity besides their cardiorespiratory deficits

INTRODUÇÃO: Indivíduos pós-AVC comumente apresentam déficits funcionais e cardiorrespiratórios, além de estilo de vida de inatividade física na fase crônica da doença. Diante disso, existe a hipótese de que as respostas hemodinâmicas possam ser afetadas por déficits motores, cognitivos e cardiorrespiratórios durante o exercício aeróbio. Para identificar as condições funcionais que podem influenciar o desempenho aeróbio desses indivíduos, foram estudadas as correlações entre as variáveis funcionais e as respostas hemodinâmicas durante e após o exercício aeróbio. Como objetivo secundário, a capacidade de retorno ao estado de repouso hemodinâmico também foi analisadaMÉTODO: Neste estudo experimental, após serem avaliados quanto à função motora e cognitiva, equilíbrio e prognóstico, quarenta participantes foram submetidos a uma sessão de exercício aeróbio de 30 minutos em esteira. A frequência cardíaca, pressão arterial, saturação periférica de oxigênio, frequência cardíaca e frequência respiratória de treinamento foram medidas antes do início da sessão de exercício, a cada cinco minutos durante o exercício e cinco minutos apósRESULTADOS: Foram observados parâmetros cardiorrespiratórios dentro dos limites da normalidade em todas as fases do exercício e capacidade de retorno ao estado de repouso. Correlações inversas moderadas foram encontradas entre Escala de Berg e saturação do pulso de oxigênio (r = -0,401, p = 0,01), entre MEEM e pressão arterial diastólica (r = -0,406, p = 0,009), idade e pressão arterial diastólica (r = -0,435, p = 0,005) e entre o tempo de lesão e FR (r = -0,454, p = 0,003). Também foi observada relação entre o lado da lesão e a fase de 20 minutos do exercício aeróbio (p = 0,042CONCLUSÃO: Indivíduos pós-AVE apresentam correlação moderada entre as respostas hemodinâmicas e respiratórias durante o exercício aeróbio e equilíbrio, força muscular, tempo de lesão, idade e lado da lesão. Eles também têm a capacidade de retornar ao estado de repouso cardiorrespiratório e cardiovascular logo após a atividade, apesar de seus déficits cardiorrespiratórios

Rebalancing thoraco-abdominal method does not increase immediate pain assessed by Neonatal Infant Pain Scale: a randomized clinical trial / O método reequilíbrio tóraco-abdominal não aumenta a dor avaliada pela Neonatal Infant Pain Scale: estudo clínico randomizado

Objective: To compare in neonates with transitory tachypnea if chest rebalancing thoraco-abdominal method (RTA) increased immediate pain. Methods: This was a randomized controlled clinical trial. Forty-nine neonates with transitory tachypnea and aged < 72 hours were included to receive either conventional physiotherapy (CP) or RTA method. Participants received usual care and one 15- minute session of chest physiotherapy. Neonatal Infant Pain Scale (NIPS), peripheral oxygen saturation, heart rate, respiratory rate, axillary temperature before and after chest physiotherapy were recorded. Kruskal-Wallis ANOVA and Mc Nemar test were used to compare differences between measures. The relative risk (RR) for pain after interventions was calculated using a Poisson regression model (robust estimation). A significance level of 5% (p < 0.05) was adopted for all analyses. Results: RTA was not associated to pain. After chest physiotherapy, NIPS reduced (2 versus 3, p < 0.001) and number of neonates with pain reduced (10.2% versus 28.6%, p = 0.02). RR for pain after chest physiotherapy in comparison to before was 0.3 (95% CI 0.15-0.41; p = 0.02); respiratory frequency decreased after chest physiotherapy (58 versus 70, p < 0.001) and peripheral oxygen saturation increased (98% versus 96%, p < 0.001). Conclusion: In neonates with transitory tachypnea, in the first 72 hours of life, RTA did not influence pain evaluation, chest physiotherapy was safe and reduced immediate pain. (AU)

Objetivo: Comparar em recém-nascidos com taquipneia transitória se o método reequilíbrio tóraco-abdominal (RTA) aumentou a dor imediatamente após. Métodos: Estudo de ensaio clínico randomizado. Quarenta e nove recémnascidos com diagnóstico de taquipneia transitória com menos de 72 horas de vida, foram incluídos para receber fisioterapia respiratória. Os participantes receberam os cuidados usuais e uma sessão de fisioterapia convencional ou do método reequilíbrio tóraco-abdominal. Foram registradas a escala NIPS (Neonatal Infant Pain Scale), a saturação periférica de oxigênio, a frequência cardíaca, a frequência respiratória e a temperatura axilar antes e depois da fisioterapia. Para as comparações entre as medidas, foram utilizados o teste de ANOVA de Kruskal-Wallis e o teste de McNemar. O risco relativo de dor após os procedimentos foi calculado usando o modelo de regressão de Poisson (estimação robusta). Foi considerado o nível de significância de 5% para todas as análises (p < 0,05). Resultados: O método RTA não foi associado a dor. Após a fisioterapia respiratória, a escala NIPS reduziu (2 versus 3, p < 0,001) e a proporção de recém-nascidos com dor também reduziu (10,2% versus 28,6%, p = 0,02). O risco relativo de dor após a fisioterapia respiratória em comparação a antes, foi de 0,3 (IC 95% 0,15-0,41; p = 0,02), a frequência respiratória diminuiu (58 versus 70, p < 0,001) e a saturação periférica de oxigênio aumentou (98% versus 96%, p < 0,001). Conclusão: Em recém-nascidos com taquipneia transitória nas primeiras 72 horas de vida, o método RTA não influenciou a avaliação da dor, a fisioterapia respiratória foi segura e reduziu a dor imediatamente após. (AU)

Physiological and hematological parameters of sheep reared in the tropics and subtropics / [Parâmetros fisiológicos e hematológicos de ovinos criados nos trópicos e nos subtrópicos]

This study aimed to determine the physiological and hematological parameters of sheep in Brazil. Therefore, 5,081 observations were used from previous experiments with animals from different Brazilian regions with the time of day, gender, breed, age, physiological characteristics, hematological and climatic variables. The animals were classified according to their stress level, and only data of non-stressed animals were used to calculate the reference values. Respiratory rate was the parameter that most differed from the normal range, with values ​​above the limits usually reported for the species, being higher in commercial wool sheep. For hematological variables, differences were observed between the present results and the previously reported values in the literature. A higher number of red blood cells (RBC), lower hemoglobin and mean corpuscular hemoglobin concentration (MCHC) were observed in young animals. A higher number of RBC and MCHC were noted in sheep crossed with local breeds. Considering that physiological and hematological parameters are indicators of the animal's pathological or physiological state, for a correct interpretation of the results, the use of reference values based on animals with similar racial characteristics and subjected to similar environmental conditions is recommended.(AU)

O objetivo deste estudo foi determinar parâmetros fisiológicos e hematológicos de ovinos no Brasil. Portanto, foram utilizadas 5.081 observações de experimentos anteriores com animais de diversas regiões do Brasil, com diferentes horário, sexo, raça, idade, características fisiológicas, variáveis ​​hematológicas e climáticas. Os animais foram classificados de acordo com o nível de estresse, e apenas os dados dos animais não estressados ​​foram utilizados para o cálculo dos valores de referência. A frequência respiratória foi o parâmetro que mais diferiu em relação à normalidade, com valores acima dos limites usualmente relatados para a espécie, sendo maior em ovinos de lã comercial. Para as variáveis ​​hematológicas, também foram verificadas diferenças entre os resultados observados e os valores previamente relatados na literatura. Maior número de hemácias, menor hemoglobina e concentração de hemoglobina corpuscular média (CHbCM) foram observados em animais jovens e maior número de hemácias e CHbCM em ovinos cruzados com raças locais. Considerando que os parâmetros fisiológicos e hematológicos são indicadores do estado patológico ou fisiológico do animal, para uma correta interpretação dos resultados recomenda-se a utilização de valores de referência baseados em animais com características raciais semelhantes e submetidos a condições ambientais também semelhantes.(AU)

Performance of the Pandemic Medical Early Warning Score (PMEWS), Simple Triage Scoring System (STSS) and Confusion, Uremia, Respiratory rate, Blood pressure and age ≥ 65 (CURB-65) score among patients with COVID-19 pneumonia in an emergency department triage setting: a retrospective study

ABSTRACT BACKGROUND: Healthcare institutions are confronted with large numbers of patient admissions during large-scale or long-term public health emergencies like pandemics. Appropriate and effective triage is needed for effective resource use. OBJECTIVES: To evaluate the effectiveness of the Pandemic Medical Early Warning Score (PMEWS), Simple Triage Scoring System (STSS) and Confusion, Uremia, Respiratory rate, Blood pressure and age ≥ 65 years (CURB-65) score in an emergency department (ED) triage setting. DESIGN AND SETTING: Retrospective study in the ED of a tertiary-care university hospital in Düzce, Turkey. METHODS: PMEWS, STSS and CURB-65 scores of patients diagnosed with COVID-19 pneumonia were calculated. Thirty-day mortality, intensive care unit (ICU) admission, mechanical ventilation (MV) need and outcomes were recorded. The predictive accuracy of the scores was assessed using receiver operating characteristic curve analysis. RESULTS: One hundred patients with COVID-19 pneumonia were included. The 30-day mortality was 6%. PMEWS, STSS and CURB-65 showed high performance for predicting 30-day mortality (area under the curve: 0.968, 0.962 and 0.942, respectively). Age > 65 years, respiratory rate > 20/minute, oxygen saturation (SpO2) < 90% and ED length of stay > 4 hours showed associations with 30-day mortality (P < 0.05). CONCLUSIONS: CURB-65, STSS and PMEWS scores are useful for predicting mortality, ICU admission and MV need among patients diagnosed with COVID-19 pneumonia. Advanced age, increased respiratory rate, low SpO2 and prolonged ED length of stay may increase mortality. Further studies are needed for developing the triage scoring systems, to ensure effective long-term use of healthcare service capacity during pandemics.

Subfenótipos baseados em dados clínicos de beira-leito de pacientes críticos com COVID-19: um estudo de coorte / Bedside clinical data subphenotypes of critically ill COVID-19 patients: a cohort study

RESUMO Objetivo: Identificar apresentações mais graves de COVID-19. Métodos: Pacientes consecutivamente admitidos à unidade de terapia intensiva foram submetidos à análise de clusters por meio de método de explorações sequenciais Resultados: Analisamos os dados de 147 pacientes, com média de idade de 56 ± 16 anos e Simplified Acute Physiological Score 3 de 72 ± 18, dos quais 103 (70%) demandaram ventilação mecânica e 46 (31%) morreram na unidade de terapia intensiva. A partir do algoritmo de análise de clusters, identificaram-se dois grupos bem definidos, com base na frequência cardíaca máxima [Grupo A: 104 (IC95% 99 - 109) batimentos por minuto versus Grupo B: 159 (IC95% 155 - 163) batimentos por minuto], frequência respiratória máxima [Grupo A: 33 (IC95% 31 - 35) respirações por minuto versus Grupo B: 50 (IC95% 47 - 53) respirações por minuto] e na temperatura corpórea máxima [Grupo A: 37,4 (IC95% 37,1 - 37,7)ºC versus Grupo B: 39,3 (IC95% 39,1 - 39,5)ºC] durante o tempo de permanência na unidade de terapia intensiva, assim como a proporção entre a pressão parcial de oxigênio no sangue e a fração inspirada de oxigênio quando da admissão à unidade de terapia intensiva [Grupo A: 116 (IC95% 99 - 133) mmHg versus Grupo B: 78 (IC95% 63 - 93) mmHg]. Os subfenótipos foram distintos em termos de perfis inflamatórios, disfunções orgânicas, terapias de suporte, tempo de permanência na unidade de terapia intensiva e mortalidade na unidade de terapia intensiva (com proporção de 4,2 entre os grupos). Conclusão: Nossos achados, baseados em dados clínicos universalmente disponíveis, revelaram dois subfenótipos distintos, com diferentes evoluções de doença. Estes resultados podem ajudar os profissionais de saúde na alocação de recursos e seleção de pacientes para teste de novas terapias.

Abstract Objective: To identify more severe COVID-19 presentations. Methods: Consecutive intensive care unit-admitted patients were subjected to a stepwise clustering method. Results: Data from 147 patients who were on average 56 ± 16 years old with a Simplified Acute Physiological Score 3 of 72 ± 18, of which 103 (70%) needed mechanical ventilation and 46 (31%) died in the intensive care unit, were analyzed. From the clustering algorithm, two well-defined groups were found based on maximal heart rate [Cluster A: 104 (95%CI 99 - 109) beats per minute versus Cluster B: 159 (95%CI 155 - 163) beats per minute], maximal respiratory rate [Cluster A: 33 (95%CI 31 - 35) breaths per minute versus Cluster B: 50 (95%CI 47 - 53) breaths per minute], and maximal body temperature [Cluster A: 37.4 (95%CI 37.1 - 37.7)°C versus Cluster B: 39.3 (95%CI 39.1 - 39.5)°C] during the intensive care unit stay, as well as the oxygen partial pressure in the blood over the oxygen inspiratory fraction at intensive care unit admission [Cluster A: 116 (95%CI 99 - 133) mmHg versus Cluster B: 78 (95%CI 63 - 93) mmHg]. Subphenotypes were distinct in inflammation profiles, organ dysfunction, organ support, intensive care unit length of stay, and intensive care unit mortality (with a ratio of 4.2 between the groups). Conclusion: Our findings, based on common clinical data, revealed two distinct subphenotypes with different disease courses. These results could help health professionals allocate resources and select patients for testing novel therapies.

Chemical restraint of coatis by the association of Detomidine, Tiletamine and Zolazepam, in allometrically scaled dosages / [Contenção farmacológica de quatis pela associação de detomidina, tiletamina e zolazepam, em doses calculadas por extrapolação alométrica]

Ten free-living adult coatis (two males and eight females) were chemically restrained with "ZAD-50", a concentrated formulation prepared with the dehydrated content of a Zoletil/50® vial diluted with 0.25mL of 1% atropine, 0.265mL of Dormiun-V®, and 2.2mL of distilled water, being exactly 3.0mL. The formula was administered to each animal previously captured and physically contained with a net. The loss of righting reflex (RR) occurred at 2.3±0.8 minutes post-injection (MPI), with anesthesia beginning at 4.4±2.7 MPI. Myorelaxant and analgesia were considered excellent at all moments of the evaluation. Conscious reactions were observed at 78.7±22.2 MPI, the return of the RR occurred at 101 ± 18 MPI, and normal ambulation was acquired at 137.0±31.0 MPI. The mean values ​​of physiological parameters measured every 10 minutes between 10 and 50 MPI were 152.2 heartbeats per minute for heart rate, 66.4 respiratory movements per minute for respiratory rate, 39.2oC for rectal temperature, 86.2% for SpO2 and 14.6 mmHg for systolic blood pressure. In the same times, the EEG registered sinus rhythm. No adverse reactions were observed, and the assessed vital parameters remained compatible with the state of chemical restraint.(AU)

Dez quatis adultos de vida livre (dois machos e oito fêmeas) foram contidos empregando-se a formulação denominada "ZAD-50". A fórmula foi preparada a partir do conteúdo desidratado de um frasco de Zoletil/50® diluído em 0,25mL de atropina a 1%, 0,265mL de Dormiun-V® e 2,2mL de água destilada, obtendo-se volume final de 3,0mL. A associação foi administrada, por via intramuscular, a cada animal capturado e contido fisicamente com puçá, em dose calculada por meio de extrapolação alométrica interespecífica. A perda da reação postural de endireitamento (RPE) ocorreu aos 2,3±0,8 minutos pós-injeção (MPI), observando-se início da anestesia aos 4,4±2,7 MPI. Miorrelaxamento e analgesia foram considerados excelentes em todos os momentos da avaliação. Reações conscientes foram observadas aos 78,7±22,2 MPI, o retorno da RPE ocorreu aos 101±18 MPI, e os animais voltaram à ambulação normal aos 137,0±31,0 MPI. Os valores médios dos parâmetros fisiológicos mensurados a cada 10 minutos entre 10 e 50 MPI foram 152,2 batimentos por minuto para frequência cardíaca, 66,4 movimentos por minuto para frequência respiratória, 39,2oC para temperatura retal, 86,2% para saturação parcial de oxigênio e 14,6mmHg para pressão arterial sistólica. Nesses tempos, observou-se ritmo sinusal no eletrocardiograma, e não foram observadas reações adversas.(AU)

Anestesia intravenosa contínua com cetamina racêmica ou dextrocetamina e detomidina em cadelas / [Continuous intravenous anesthesia with racemic ketamine or dextroketamine and detomidine in female dogs]

Objetivou-se com este estudo comparar a associação de detomidina e cetamina ou dextrocetamina, por via intravenosa contínua, em oito cadelas submetidas a dois protocolos: GCD - indução anestésica com 5mg/kg e infusão intravenosa contínua de 20mg/kg/h de cetamina; e GDD - indução com 3,5mg/kg e infusão de 14mg/kg/h de dextrocetamina. Associou-se detomidina, 30µg/kg/h, em ambos os grupos. Registraram-se frequência cardíaca (FC), pressão arterial (PA), frequência respiratória (f), temperatura (TC), miorrelaxamento, analgesia, hemogasometria e eletrocardiograma, antes e 15 minutos após a MPA (Mbasal e Mmpa); após o início da infusão (Mic); a cada 10 minutos até 90 minutos (M10, M20, M30, M40, M50, M60, M70, M80 e M90); e 30 minutos após o fim da infusão (M120). Foi observada bradicardia em Mmpa no GCD e de Mmpa a M10 no GDD. Ocorreu hipotensão em Mmpa e hipertensão a partir de Mic. A f diminuiu de M10 a M30. Foram observados: onda T de alta amplitude, bloqueios atrioventriculares e parada sinusal. Ocorreu acidose respiratória. O período de recuperação foi de 219,6±72,3 minutos no GCD e de 234,1±96,8 minutos no GDD. A cetamina e a dextrocetamina, associadas à detomidina por infusão contínua, causam efeitos cardiorrespiratórios e anestésicos similares.(AU)

The combination of detomidine and ketamine or dextrocetamine for continuous intravenous infusion was compared in eight female dogs submitted to two protocols: GCD - 5mg/kg of anesthetic induction and continuous intravenous infusion of ketamine 20mg/kg/h; and GDD - induction with 3.5mg/kg and infusion of 14mg/kg/h of dextrocetamine. Detomidine, 30µg/kg/h was associated in both groups. Heart rate (HR), blood pressure (BP), respiratory rate (RR), temperature (CT), myorelaxation, analgesia, blood gas analysis and electrocardiogram were recorded before and 15 minutes after MPA (Mbasal and Mmpa); after the start of infusion (Mic); every 10 minutes to 90 minutes (M10, M20, M30, M40, M50, M60, M70, M80 and M90); and 30 minutes after the end of infusion (M120). Bradycardia was observed in Mmpa in GCD and from Mmpa to M10 in GDD. There was hypotension in Mmpa and hypertension from Mic. The RR decreased from M10 to M30. High amplitude T wave, atrioventricular blocks and sinus arrest were observed. Respiratory acidosis occurred. The recovery period was 219.6±72.3 minutes in GCD and 234.1±96.8 minutes in GDD. Ketamine and S+ ketamine associated with detomidine for continuous infusion cause cardiorespiratory and similar anesthetic effects.(AU)

Evaluation of acute cardiorespiratory and hemodynamic changes in perioperative intravenous antimicrobial applications in cats / [Avaliação das alterações cardiorespiratórias e hemodinâmicas agudas em aplicações pré-operatórias de antimicrobianos, pela via intravenosa, em gatos]

The metabolic peculiarities of felines favor an intoxication. Fifty healthy female cats were divided into five groups: PG (placebo group), G2 (cefazolin), G3 (ceftriaxone), G4 (enrofloxacin) and G5 (ampicillin) were used. The parameters evaluated were: total expired carbon dioxide (ETCO2), oxygen saturation in hemoglobin (SpO2), heart rate (HR), respiratory rate (RR), body temperature (BT), systolic, mean and diastolic blood pressure (SBP, mBP and DBP) by invasive method, at T0, 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25) and 30 (T30) minutes after administration of the treatments. HR presented reduction in G2 compared to PG at all times, except T20, and in G4, T25 and T30 were lower than the T0 values (P<0.05). BT showed increase in the G3 at T0 and T5 and all groups showed reduction in the values of BT relative to T0 (P<0.05). ETCO2 increased in G2 and G5 at all times compared to PG (P<0.05) and there were no differences among the times within each group. It was concluded that ceftriaxone is safer for the prophylactic antimicrobial use in cats, however the other antimicrobials are also indicated, because all the parameters, in all groups, basically did not change over the study and when this occurs it remains in reference interval.(AU)

As peculiaridades metabólicas dos felinos favorecem quadro de intoxicação. Foram utilizadas 50 gatas saudáveis, que foram divididas em cinco grupos: GP (grupo placebo), G2 (grupo cefazolina), G3 (grupo ceftriaxona), G4 (grupo enrofloxacina) e G5 (grupo ampicilina). Os seguintes parâmetros foram avaliados: dióxido de carbono expirado (ETCO2), saturação de oxigênio na hemoglobina (SpO2), frequência cardíaca (FC), frequência respiratória (FR), temperatura corporal (T°C), pressão arterial sistólica,média e diastólica (PAS, PAM e PAD), pelo método invasivo, em 0 (T0), 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25) e 30 (T30) minutos após a administração dos tratamentos. A FC apresentou redução no G2 em relação ao GP em todos os momentos, exceto no T20, e, no G4, o T25 e o T30 foram inferiores aos valores do T0 (P<0,05). A T°C apresentou aumento no G3 no T0 e no T5, e todos os grupos apresentaram redução nos valores da T°C em relação ao T0 (P<0,05). O ETCO2 apresentou aumento no G2 e no G5, em todos os momentos, em relação ao GP (P<0,05). Concluiu-se que a ceftriaxona é mais segura para uso profilático em gatos, entretanto os outros antibióticos também são recomendados, pois todos os parâmetros praticamente não se modificaram e, quando alterados, mantiveram-se dentro dos padrões de referência.(AU)

Respiratory mechanics behavior after heart surgery: an experimental study

Changes in ventilatorymechanics and their consequent pulmonary complications are common after surgical procedures, particularly in cardiac surgery (CS), and may be associated with both preoperative history and surgical circumstances. This study aims to compare ventilatory mechanics in the moments before and after cardiac surgery (CS), describing how pulmonary complications occurred. An experimental, uncontrolled study was conducted, of the before-and-after type, and with a descriptive and analytical character. It was carried out in a private hospital in the city of Salvador, Bahia, Brazil, and involved 30 adult patients subjected to CS. In addition to clinical and epidemiological variables, minute volume (VE), respiratory rate (RR), tidal volume (VT), forced vital capacity (FVC), maximum inspiratory pressure (MIP), and peak expiratory flow (PEF) were also recorded. Data were collected in the following moments: preoperative (PRE-OP) period, immediate postoperative (IPO) period, and 1stpostoperative day (1stPOD). The sample was aged 48.1 ± 11.8 years old and had a body mass index of 25.5 ± 4.9 kg m-2; 60% of the patients remained on mechanical ventilation for less than 24 hours (17.5 [8.7-22.9] hours). There was a significant reduction in VT, FVC, MIP and PEF when PRE-OP versus IPO, and PRE-OP versus 1stPOD were compared (p < 0.05). There were no significant changes between IPO and the 1stPOD. The highest incidence of pulmonary complications involved pleural effusion (50% of the patients). This study showed that patients subjected to CS present significant damage to ventilatory parameters after the surgery, especially in the IPO period and on the 1stPOD. It is possible that the extension of this ventilatory impairment has led to the onset of postoperative pulmonary complications.

Research on non-contact respiratory rate measurement method based on video information / 生物医学工程学杂志

Traditional methods of non-contact human respiratory rate measurement usually require complex devices or algorithms. Aiming at this problem, a non-contact respiratory rate measurement method based on only the RGB video information was proposed in this paper. The method consisted of four steps. Firstly, spatial filtering was applied to each frame of the input video. Secondly, a gray compensation algorithm was used to compensate for the gray level change caused by the environmental light. Thirdly, the gray levels of each pixel over time were filtered separately by a low-pass filter. Finally, the region of interest was determined based on the filtering results, and the respiration rate of the human is measured. The physical measurement experiments were designed, and the measurement accuracy was compared with that of the biological radar. The error of the proposed method was between - 5.5% and 3% in different detection directions. The results show that the non-contact respiration rate measurement method can effectively measure the human respiration rate.

Review on Development of Heart Rate and Respiratory Core Vital Characteristics Monitoring Technology / 中国医疗器械杂志

Life monitoring technology as the basis of health evaluation, in recent years, its related technology research also has new development, in which cardiopulmonary parameters are the core physiological indicators to measure the basic state of vital signs, the analysis of its monitoring technology is particularly important. In this study, the main means of life monitoring are analyzed, and the monitoring technology of cardiopulmonary parameters is the main focus. What is more, the research status and development of contact and non-contact cardiopulmonary monitoring technology at home and abroad were also considered. Lastly, this study will be combined with the radar wave vital signs monitoring technology, which has been achieved good results in the field of cardiopulmonary monitoring, in order to provide a reference for the long-term development of life monitoring field and the technology integration of intelligent pension, intelligent automobile and other related industries.

Development of Respiratory Signal Extraction System Based on Photoplethysmography / 中国医疗器械杂志

Oxygen saturation and respiratory signals are important physiological signals of human body, respiratory monitoring plays an important role in clinical and daily life. A system was established to extract respiratory signals from photoplethysmography in this study. Including the collection of pulse wave signal, the extraction of respiratory signal, and the calculation of respiratory rate and pulse rate transmitted from the slave computer to the host computer in real time.

Physiological and biochemical responses and hydration status in equines after two barrel racing courses / Respostas fisiológicas e bioquímicas e status de hidratação em equinos após dois percursos de três tambores

Studies on biochemical constituents and hydration of horses in training or competitions are essential for the knowledge of their adaptive physiological and metabolic responses to the type of exercise inherent to the sport. The present research evaluated the effects of exercise on hydric status and physiologic and biochemical profiles in Quarter Horses during a barrel race training session. The design consisted of three evaluation times (T): at rest, before the start of physical activity (T0); immediately after a 10-minute warm-up trot and then running the barrel race courses twice with a 10-minute interval (T1); and after one hour's rest after the second course (T2). The parameters analyzed were: heart rate (HR), respiratory rate (RR), body temperature (BT) and mucose color; the capillary refill time (CRT), packed cell volume (PCV), total plasma proteins (TPP), serum creatinine (CRE) and blood urea nitrogen (BUN) were evaluated and used to infer water status; plasma osmolarity (Osm) was measured; the electrolytes sodium (Na), potassium (K), chloride (Cl), total calcium (tCa), total magnesium (tMg) and phosphorus (P), plasma glucose (Glu) and lactate (Lac) and the muscle enzymes creattine kinase (CK) and aspartate aminotransferase (AST) completed the evaluated parameters. The data for the variables studied were submitted to ANOVA and the Tukey test at 5% probability. After exercise (in T1), HR, RR, BT, PCV, TPP, Glu, Lac, Cre increased (P<0.05), there was also increase in phosphorus and decrease in K (P<0.05), but there was no hypophosphatemia and hipokalemia, respectively. After rest (in T2), only glucose returned to baseline levels (T0) and, with lower mean values, HR, RR, BT, PCV, K and Lac did not return to baseline levels (T0), while P decreased (P<0.05). Osm, BUN, Na, Cl, tCa, tMg, CK and AST did not change between times (P>0.05). It was concluded that the maximum intensity exercise performed on two barrel race courses caused mild hemoconcentration, did not changed plasma osmolality or concentrations of important electrolytes and muscle enzymes of horses, but caused hyperlactatemia without the plasma lactate concentrations being fully recomposed after resting.(AU)

O perfil bioquímico e o status de hidratação de equinos em treinamentos ou competições fornecem dados importantes das suas respostas fisiológicas e metabólicas em relação ao tipo específico de exercício em uma modalidade esportiva. No presente estudo, o status hídrico e o perfil fisiológico-bioquímico de equinos foram avaliados durante treinamento de três tambores, em três tempos (T): em repouso, antes do início da atividade física (T0); imediatamente após 10 minutos de aquecimento ao trote seguido de duas corridas na pista de tambor, intervaladas em 10 minutos (T1); e após uma hora de descanso do segundo percurso (T2). Os parâmetros avaliados foram: frequência cardíaca (FC), frequência respiratória (FR), temperatura corporal (BT) e cor da mucosa; o tempo de enchimento capilar (TEC), volume globular ou hematócrito (VG), proteínas plasmáticas totais (TPP), creatinina sérica (Cre) e a ureia (Ure) foram avaliados e utilizados para inferir o estado hídrico dos animais; a osmolaridade plasmática (Osm) também foi mensurada; as concentrações dos eletrólitos sódio (Na), potássio (K), cloreto (Cl), cálcio total (tCa), magnésio total (tMg) e fósforo (P), e das enzimas musculares foram mensurados no soro, e as de glicose (Gli) e lactato (Lac) no plasma. Os dados das variáveis estudadas foram submetidos à ANOVA e ao teste de Tukey a 5% de probabilidade. Após o exercício (T1), a FC, FR, TC, VG, TPP, Gli, Lac, Cre aumentaram. O P também aumentou (P<0,05), mas não alcançou nível de hiperfosfatemia, e o K diminuiu (P<0,05), mas não ao nível de hipocalemia. Embora com médias menores, a FC, FR, TC, VG, K e o Lac não retornaram aos níveis basais (T0) após o repouso (T2), apenas a Gli, enquanto o fósforo diminuiu (P<0,05). A Osm, ureia, Na, Cl, tCa, tMg, CK e AST não variaram entre os tempos (P>0,05). Concluiu-se que, o exercício de intensidade máxima realizado em dois percursos de três tambores causou leve hemoconcentração, não alterou a osmolaridade plasmática nem importantes concentrações de eletrólitos e de enzimas musculares dos equinos, porém, causou hiperlactatemia, sem completa recomposição da concentração do lactato após uma hora de descanso.(AU)