FRANCINNI MAMBRINI PIRES REGO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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    Condutas em vias aéreas difíceis
    (2013) RêGO, Francinni Mambrini Pires; FERRAZ, Janice Leão
  • article
    Construção de substituto da pele composto por matriz de colágeno porcino povoada por fibroblastos dérmicos e queratinócitos humanos: avaliação histológica
    (2012) ISAAC, Cesar; REGO, Francinni M. P.; LADEIR, Pedro Ribeiro Soares de; ALTRAM, Silvana C.; OLIVEIRA, Renata C. de; ALDUNATE, Johnny L. C. B.; PAGGIARO, André O.; FERREIRA, Marcus Castro
    BACKGROUND: In the case of extensive lesions, the use of autologous grafts is limited by the extent of the donor area and the clinical condition of patients. Allografts collected from cadavers or volunteers are usually rejected after 1 to 2 weeks, thus serving only as temporary cover for these lesions. Treating major cutaneous lesions with reconstructed autologous skin is an attractive alternative, because it is possible to obtain cultures of cells that multiply rapidly and can be cryopreserved from a small fragment of the patient's skin, thereby facilitating its indefinite use in new treatments. This study evaluated the histological behavior of cultured human keratinocytes and fibroblasts on a collagen matrix derived from porcine small intestinal submucosa. METHODS: Cells from human epidermis and dermis were grown separately and seeded on porcine collagen matrix, which was maintained in a controlled environment for 21 days before being subjected to histological analysis. RESULTS: Fibroblasts invaded and colonized the collagen matrix, whereas keratinocytes were organized in laminated and stratified layers on the surface on which they were seeded. CONCLUSIONS: The use of porcine collagen matrix as a support for human skin cells is feasible, and the organization of these cells resembles the architecture of human skin.
  • article 2 Citação(ões) na Scopus
    Performance of Noninvasive Ventilation Masks in a Lung Model of COPD Exacerbation
    (2019) MACEDO, Bruno Rocha de; REGO, Francinni Mambrini Pires; SILVA, Fabia Diniz; PINAFFI, Juliana Valerio; FERREIRA, Juliana Carvalho
    BACKGROUND: Noninvasive ventilation (NIV) reduces intubation and mortality in patients with COPD exacerbation who present with respiratory failure, and the type of mask may affect its success. Our objective was to compare the performance of 3 different NIV masks in a lung model. METHODS: We set the lung simulator mechanics and respiratory rate, and tested a small oronasal mask, a total face mask, and a large oronasal mask. We added CO2 at a constant rate into the system and monitored the end-tidal carbon dioxide. We used a mechanical ventilator to deliver NW in 8 different combinations of inspiratory effort, pressure support, and expiratory positive airway pressure. We measured end-tidal carbon dioxide mask leakage, tidal volume, trigger time, time to achieve 90% of the inspiratory target during inspiration, and excess inspiratory time. RESULTS: We presented the mean +/- SD of the 8 simulated conditions for each mask. The mean +/- SD leakage was higher for the total face mask (51 +/- 6 L/min) than for the small oronasal mask (37 +/- 5 L/min) and for the large oronasal mask (21 +/- 3 L/min), P < .001; but end-tidal carbon dioxide and tidal volume were similar. The mean +/- SD 90% of the inspiratory target during inspiration was faster for the small oronasal mask (585 +/- 49 ms) compared with the large oronasal (647 +/- 107 ms) and total face mask (851 +/- 105 ms), P < .001, all other variables were similar. CONCLUSIONS: In this model, we found that the type of mask had no impact on CO2 washout or on most synchrony variables.
  • article 1 Citação(ões) na Scopus
    Long-Term Pulmonary Vascular Reactivity After Orthotopic Heart Transplantation by the Biatrial Versus the Bicaval Technique
    (2011) FIORELLI, A. I.; SANTOS, R. H. B.; OLIVEIRA JR., J. L.; SILVA, M. A. F. Da; SANTOS JR., V. P. dos; REGO, F. M. P.; SOUZA, G. E.; BACAL, F.; BOCCHI, E. A.; STOLF, N. A. G.
    Introduction. Advantages of the bicaval versus the biatrial technique have been reported, emphasizing atrial electrical stability and less tricuspid regurgitation. Objective. To analyze the impact of the surgical technique on long-term pulmonary pressures, contractility, and graft valvular behavior after heart transplantation. Methods. Among 400 orthotopic heart transplantation recipients from 1985 to 2010, we selected 30 consecutive patients who had survived beyond 3 years. The biatrial versus bicaval surgical technique groups included 15 patients each. Their preoperative clinical characteristics were similar. None of the patients displayed a pulmonary vascular resistance or pulmonary artery pressure over 6U Wood or 60 mm Hg, respectively. We evaluated invasive hemodynamic parameters during routine endomyocardial biopsies. Two-dimensional echocardiographic parameters were obtained from routine examinations. Results. There were no significant differences regarding right atrial pressure, systolic pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance, cardiac index, systolic blood pressure, left ventricular ejection fraction, and mitral regurgitation (P > .05). Tricuspid regurgitation increased significantly over the 3 years of observation only among the biatrial group (P = .0212). In both groups, the right atrial pressure, pulmonary wedge capillary pressure, transpulmonary gradient, and pulmonary vascular resistance decreased significantly (P < .05) from the pre- to the postoperative examination. In both groups cardiac index and systemic blood pressure increased significantly after transplantation (P < .05). Comparative analysis of the groups only showed significant differences regarding right atrial pressure and degree of tricuspid regurgitation; the bicaval group showing the best performance. Conclusions. Both surgical techniques ensure adequate left ventricular function in the long term; however, the bicaval technique provided better trends in hemodynamic performance, as well as a lower incidence and severity of tricuspid valve dysfunction.
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    Characteristics And Outcomes Of Patients With Interstitial Lung Disease Who Require Mechanical Ventilation: A Retrospective Study
    (2013) FERREIRA, J. C.; REGO, F. M. P.; TEIXEIRA, F. B.; NAPPI, C.; KAIRALLA, R. A.; CARVALHO, C. R. R.
  • article 26 Citação(ões) na Scopus
    Risk factors for noninvasive ventilation failure in cancer patients in the intensive care unit: A retrospective cohort study
    (2015) FERREIRA, Juliana Carvalho; MEDEIROS JR., Pedro; REGO, Francinni Mambrini; CARUSO, Pedro
    Purpose: The purpose of the study is to identify risk factors for noninvasive ventilation (NIV) failure in cancer patients with acute respiratory failure (ARF). Materials and methods: A retrospective cohort study of adult patients admitted to intensive care unit (ICU), who received NIV for treatment of ARF, was conducted. We conducted a chart review to estimate the NIV failure rate and used logistic regression to identify risk factors. Results: Of 2258 patients admitted to the ICU during the study period, 114 (5%) received NIV for ARF. Noninvasive ventilation was successful in 67 patients (59%) and failed for 47 (41%), of whom 36 were intubated and 11 were sedated for palliation. Factors associated with NIV failure were infection as the primary cause of ARF (odds ratio [OR], 4.90; 95% confidence interval [CI], 1.78-13.45; P = .002), male sex (OR, 2.58; 95% CI, 1.20-5.56; P = .015), and Simplified Acute Physiology Score 3 (OR, 1.04; 95% CI, 1.01-1.07; P = .006). Overall ICU mortality was 40%, and hospital mortality was 56%. Noninvasive ventilation failure was the only independent predictor of ICU mortality (OR, 16.6; 95% CI, 6.5-41.5; P < .001). Conclusions: Noninvasive ventilation can avert ARF for most ICU cancer patientswith ARF. For patients with pulmonary infections and high severity scores, NIV should be used with caution. Identifying risk factors for NIV failure using a comprehensive diagnostic approach and monitoring of NIV are paramount to improve outcomes.