Dr. Jose Carvalho, MD
Claim this profileMount Sinai Hospital
Studies Postpartum Hemorrhage
Studies Bleeding
7 reported clinical trials
11 drugs studied
Affiliated Hospitals
Clinical Trials Jose Carvalho, MD is currently running
Oxytocin
for Postpartum Hemorrhage
This study is designed to determine the minimal effective oxytocin maintenance infusion required in labouring women undergoing cesarean delivery to achieve the best effect. Oxytocin is a drug that is routinely used to help the uterus to contract and keep it contracted after delivery. Consequently, it will help to reduce blood loss after delivery. In order to determine the minimal effective dose, the investigators will conduct a dose-finding study. The first patient will receive a set oxytocin infusion. The next patient's infusion dose of oxytocin, will either increase or decrease, depending on how the previous patient responds in terms of uterine tone. If the response is satisfactory with the infusion dose used, the next patient will either receive the same infusion dose or it will be decreased depending on a probability of 1:9. If the response is not satisfactory, then the infusion dose will increase for the next patient. The dose for each patient will be determined based on the results of the uterine contraction of the previous patient. The investigators hypothesize that the ED90 of the oxytocin infusion rate to maintain adequate uterine tone in labouring women with induced or augmented labour undergoing cesarean delivery, following an initial effective bolus dose, would be lower than 0.74 IU/min (44 IU/h), which was found as the ED90 in a previous study, without an initial bolus dose prior to the infusion.
Recruiting1 award N/A
Vasopressors
for Low Blood Pressure
Hypotension is one of the most common adverse effects of spinal anesthesia for cesarean deliveries, affecting as many as 55-90% of mothers. Hypotension during cesarean deliveries can have detrimental effects on the mother and neonate. Various vasopressors, such as ephedrine, phenylephrine and more recently norepinephrine, have been used for the prevention and treatment of hypotension at cesarean deliveries. Ephedrine was historically considered as the gold standard vasopressor for the management of hypotension during cesarean deliveries. This was based on studies in animal models that showed preserved uteroplacental circulation with ephedrine and not with phenylephrine. However, multiple studies in the past several decades have shown that phenylephrine compared with ephedrine results in a more favorable fetal acid-base status. Consequently, the use of phenylephrine for blood pressure management during cesarean deliveries increased. Recently, norepinephrine was introduced in the obstetrical practice for the management of hypotension at cesarean deliveries, due to its ability to maintain maternal cardiac output better than phenylephrine. Studies have also investigated the use of vasopressin to limit hypotension during CD. There have been case reports of successful vasopressin usage to treat post-spinal hypotension after CD in patients with advanced idiopathic pulmonary arterial hypertension as well as severe mitral stenosis with pulmonary hypertension. Its effect was associated with hemodynamic stability without evidence of harm to the mother or child. However, much controversy still exists surrounding the choice of vasopressor in the obstetric population, in large part due to their varying efficacies, and maternal and fetal effects. Vasopressors used for the treatment of hypotension during cesarean deliveries can have significant direct or indirect effects on the perfusion of uteroplacental and umbilical vessels. Reduction of uteroplacental perfusion and constriction of umbilical vessels can result in fetal acidosis, however, the mechanisms for these effects are unclear. The investigators hypothesize that ephedrine, phenylephrine and norepinephrine and vasopressin have variable effects on the contractility of pregnant myometrium and umbilical arteries due to their variable actions on adrenergic alpha (α) and beta (β) receptors, as well as vasopressin1 and vasopressin2 receptors located in these tissues.
Recruiting1 award N/A6 criteria
More about Jose Carvalho, MD
Clinical Trial Related5 years of experience running clinical trials · Led 7 trials as a Principal Investigator · 3 Active Clinical TrialsTreatments Jose Carvalho, MD has experience with
- Oxytocin
- Ultrasound
- Ephedrine
- Phenylephrine
- Norepinephrine
- Vasopressin
Breakdown of trials Jose Carvalho, MD has run
Postpartum Hemorrhage
Bleeding
Low Blood Pressure
Airway Complication
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Frequently asked questions
Do I need insurance to participate in a trial?
Almost all clinical trials will cover the cost of the ‘trial drug’ — so no insurance is required for this. For trials where this trial drug is given alongside an already-approved medication, there may be a cost (which your insurance would normally cover).
What does Jose Carvalho, MD specialize in?
Jose Carvalho, MD focuses on Postpartum Hemorrhage and Bleeding. In particular, much of their work with Postpartum Hemorrhage has involved treating patients, or patients who are undergoing treatment.
Is Jose Carvalho, MD currently recruiting for clinical trials?
Yes, Jose Carvalho, MD is currently recruiting for 3 clinical trials in Toronto Ontario. If you're interested in participating, you should apply.
Are there any treatments that Jose Carvalho, MD has studied deeply?
Yes, Jose Carvalho, MD has studied treatments such as Oxytocin, Ultrasound, Ephedrine.
What is the best way to schedule an appointment with Jose Carvalho, MD?
Apply for one of the trials that Jose Carvalho, MD is conducting.
What is the office address of Jose Carvalho, MD?
The office of Jose Carvalho, MD is located at: Mount Sinai Hospital, Toronto, Ontario M5G1X5 Canada. This is the address for their practice at the Mount Sinai Hospital.
Is there any support for travel costs?
The coverage of travel expenses can vary greatly between different clinical trials. Please see more financial detail in the trials you’re interested to apply.