JOEL AVANCINI ROCHA FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/08 - Laboratório de Anestesiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
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article 1 Citação(ões) na Scopus Experimental Model of Non-Controlled Hemorrhagic Shock in Pigs(2011) CAVALCANTE, Fernanda Paula; NANI, Ricardo Souza; ROCHA FILHO, Joel Avancini; AULER JUNIOR, Jose Otavio Costa; CARMONA, Maria Jose Carvalho; MACHADO, Marcel Cerqueira CesarCavalcante FP, Nani RS, Rocha Filho JA, Auler Junior JOC, Carmona MJC, MachadoMCC - Experimental Model of Non-Controlled Hemorrhagic Shock in Pigs. Background and objectives: A better understanding of pathophysiologic changes associated to trauma and hemorrhagic shock can help the development of therapies capable of reducing trauma-related mortality. The objective of this study was to describe a model of non-controlled hemorrhagic shock in pigs. Methods: Animals received ketamine and midazolam as pre-anesthetic medications. Anesthesia was induced with propofol, and tracheal intubation was performed with the animals on spontaneous ventilation. After intubation neuromuscular blockade was performed. Animals were maintained in controlled mechanical ventilation and normocapnia. Anesthesia was maintained with propofol and fentanyl as needed. Saline was infused during the entire preparation period. Monitoring: Cardioscope, pulse oximeter, invasive blood pressure, volumetric catheter in the pulmonary artery, and urine output by cystostomy were used. Experimental model: after the initial recording of hemodynamic, metabolic, and coagulation variables, right subcostal incision and left lobe liver biopsy were performed. Anesthetic infusion was reduced while the infusion of saline was interrupted. An incision 12 cm long 2 cm deep was performed in the right liver lobe followed by digital divulsion of the wound. During the hemorrhagic phase, an aspiration probe was placed close to the wound and the volume of aspirated blood was recorded. When mean arterial pressure reached 40 mmHg and bleeding was above 700 mL the intervention phase was initiated according to the type of study. Conclusion: The development of experimental models to reduce high mortality and costs related to trauma is important.- Nutritional support for fulminant hepatitis(2015) FIGUEIRA, Estela Regina Ramos; ROCHA FILHO, Joel Avancini; NACIF, Lucas Souto; D'ALBUQUERQUE, Luiz Carneiro; WAITZBERG, Dan LinetzkyIntroduction: fulminant hepatitis (FH) is associated with exacerbated hypercatabolism, hypoglycemia and hyperammonemia that are accompanied by the release of proinflammatory cytokines and catabolic hormones into the systemic circulation worsening patient's clinical condition. Nutritional support is a crucial element for the recovery of these patients. Objectives: the aim of this review is to update Nutritional Support for Fulminant Hepatitis. Methods: the review was performed using electronic search on Medline-PubMed using Mesh-terms. Results and discussion: there are not many data available on nutritional support to fulminant hepatitis or acute liver failure. Strategies for initial nutritional intervention are focused on the control of the previously described FH metabolic derangements, and should be individualized according to the severity of patient's clinical condition. Energy and protein can be provided in amounts of 25-40 kcal/kg/day and 0.8-1.2 g/kg/day, respectively. Enteral nutrition therapy is indicated for patients with advancing encephalopathy or for those who cannot be properly fed orally. Euglycemia must be achieved and protein intake can be based on BCAA formulae. Lipids can be administered as energy supplementation with caution. Adequate nutrition therapy can potentially reduce morbidity and mortality of FH patients.
bookPart Anestesia para Transplante de Intestino Delgado e Multivisceral(2021) ROCHA FILHO, Joel Avancini; VIEIRA, Roberta Figueiredo; D´OTTAVIANO, Marcello de Oliveira; RIBEIRO, Juliana SoaresbookPart Manejo básico das vias aéreas e intubação traqueal(2013) MARCHETTI, Kátia Regina; HORTêNCIO, Lucas de Oliveira Serra; ROCHA FILHO, Joel Avancini; FERRAZ, Janice LeãobookPart Anestesia para Transplante Hepático(2021) GORDON, Karina; ROCHA FILHO, Joel AvancinibookPart Anestesia para Transplante de Pâncreas(2017) ALMEIDA, Eduardo Montoyama de; NANI, Fernando Souza; ROCHA FILHO, Joel AvancinibookPart Avaliação pré-anestésica no transplante de figado(2018) D'OTTAVIANO, Marcello de Oliveira; ROCHA FILHO, Joel AvancinibookPart Hepatite fulminante(2016) PEREIRA, Sérgio Martins; VANE, Matheus Fachini; ROCHA FILHO, Joel AvancinibookPart Anestesia para Transplante de Intestino Delgado e Multivisceral(2017) ROCHA FILHO, Joel Avancini; PRETO, Ernesto A.; D'OTTAVIANO, Marcelo Oliveira- Does autologous blood transfusion during liver transplantation for hepatocellular carcinoma increase risk of recurrence?(2016) ARAUJO, Raphael L. C.; PANTANALI, Carlos Andres; HADDAD, Luciana; ROCHA FILHO, Joel Avancini; D'ALBUQUERQUE, Luiz Augusto Carneiro; ANDRAUS, WellingtonAIM: To analyze outcomes in patients who underwent liver transplantation (LT) for hepatocellular carcinoma (HCC) and received autologous intraoperative blood salvage (IBS). METHODS: Consecutive HCC patients who underwent LT were studied retrospectively and analyzed accor-ding to the use of IBS or not. Demographic and sur-gical data were collected from a departmental pro-spective maintained database. Statistical analyses were performed using the Fisher's exact test and the Wilcoxon rank sum test to examine covariate differences between patients who underwent IBS and those who did not. Univariate and multivariate Cox regression models were developed to evaluate recurrence and death, and survival probabilities were estimated using the Kapla-Meier method and compared by the log-rank test. RESULTS: Between 2002 and 2012, 158 consecutive patients who underwent LT in the same medical center and by the same surgical team were identified. Among these patients, 122 (77.2%) were in the IBS group and 36 (22.8%) in the no-IBS group. The overall survival (OS) and recurrence free survival (RFS) at 5 years were 59.7% and 83.3%, respectively. No differences in OS (P = 0.51) or RFS (P = 0.953) were detected between the IBS and no-IBS groups. On multivariate analysis for OS, degree of tumor differentiation remained as the only independent predictor. Regarding patients who received IBS, no differences were detected in OS or RFS (P = 0.055 and P = 0.512, respectively) according to the volume infused, even when outcomes at 90 d or longer were analyzed separately (P = 0.518 for both outcomes). CONCLUSION: No differences in RFS or OS were detected according to IBS use. Trials addressing this question are justified and should be designed to detect small differences in long-term outcomes.