Mirizana Alves de Almeida
@unichristus.edu.br
Professor - Fisioterapia/Radiologia
Centro Universitário Christus - Unichristus
Atualmente é pesquisadora do Laboratório da Respiração - RespLab (2007- atual) e Professora do Cento Universitário Christus - UNICHRISTUS (2004 - atual). Tem experiência na área de Fisiologia Humana, Metodologia Científica e Patologia Geral, com ênfase em Fisiologia da Respiração e Muscular, atuando principalmente nos seguintes temas: Fisiologia, Ensino em Fisiologia, Perfis Epidemiológicos, Fisiologia Muscular e Respiratória, DPOC, VNI, Fisioterapia Cardiopulmonar e Fisioterapia Baseada em Evidencias.
EDUCATION
Graduação em Fisioterapia pela Universidade de Fortaleza - UNIFOR (2000), Aprimoramento em Fisioterapia Hospitalar pelo Hospital Universitário Walter Cantídeo - HUWC/UFC (2001), Especialização em Ciências Fisiológicas (2003) e Mestrado Acadêmico em Ciências Fisiológicas pela Universidade Estadual do Ceará - UECE, com área de concentração em Fisiologia Respiratória na UFRJ (2004) e Doutorado Acadêmico em Ciências Médicas pela Universidade Federal do Ceará - UFC, com área de concentração em Medicina Intensiva - VNI (2011).
RESEARCH INTERESTS
Fisiologia Humana
Fisioterapia
Ensino Superior
Educação
Pneumologia
Fisioterapia cardiorrespiratória
Metodologia Cientifica
Patologia Humana
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Marcelo A. Holanda, Mirizana Alves-de-Almeida, José W.O. Lima, Tauily C.D. Taunay, Francisco A.A. Gondim, Renesa P.R.Cavalcanti, Francisco J.A. Mont’Alverne, Nancy Delma S.V.C. Sousa, Mayron F. Oliveira, and Eanes D.B. Pereira
Elsevier BV
Renata dos S. Vasconcelos, Luíz Henrique de P. Melo, Raquel P. Sales, Liégina S. Marinho, Flávio C. Deulefeu, Ricardo C. Reis, Mirizana Alves-de-Almeida, and Marcelo A. Holanda
S. Karger AG
<b><i>Background:</i></b> The digital Auto-Trak™ system is a technology capable of automatically adjusting the triggering and cycling mechanisms during pressure support ventilation (PSV). <b><i>Objective:</i></b> To compare Auto-Trak with conventional settings in terms of patient-ventilator synchrony and discomfort. <b><i>Methods:</i></b> Twelve healthy volunteers underwent PSV via the mouth by breathing through an endotracheal tube. In the conventional setting, a pressure support of 8 cm H<sub>2</sub>O with flow cycling (25% peak inspiratory flow) and a sensitivity of 1 cm H<sub>2</sub>O was adjusted. In Auto-Trak the triggering and cycling were automatically set. Discomfort, effort of breathing, and the asynchrony index (AI) were assessed. In a complementary bench study, the inspiratory and expiratory time delays were quantified for both settings in three mechanical models: ‘normal', obstructive (COPD), and restrictive (ARDS), using the ASL 5000 simulator. <b><i>Results:</i></b> In the volunteer study the AI and the discomfort scores did not differ statistically between the two settings. In the bench investigation the use of Auto-Trak was associated with a greater triggering delay in the COPD model and earlier expiratory cycling in the ARDS model but with no asynchronic events. <b><i>Conclusions:</i></b> Use of the Auto-Trak system during PSV showed similar results in comparison to the conventional adjustments with respect to patient-ventilator synchrony and discomfort in simulated conditions of invasive mechanical ventilation.
Marcelo A. Holanda, Simone C.B. Fortaleza, Mirizana Alves-de-Almeida, Georgia F.P. Winkeler, Ricardo C. Reis, John H.S. Felix, José W.O. Lima, and Eanes D.B. Pereira
Elsevier BV
BACKGROUND
The effects of nasal continuous positive airway pressure (CPAP) on the lung parenchyma of patients with COPD, to our knowledge, have never been assessed by high-resolution CT (HRCT) scanning.
METHODS
HRCT scans were obtained at the apex, hilum, and basis of the lungs at functional residual capacity while on spontaneous respiration and at the end of CPAP trials of 5 cm water (H(2)O), 10 cm H(2)O, and 15 cm H(2)O in 11 stable patients with COPD and eight healthy volunteers. Lung aeration was assessed by quantitative density parameters and by qualitative analysis of each CT image after processing by means of a density-based color-mask computational algorithm. The quantitative parameters were density histograms, the relative area of the lungs with attenuation values < -950 Hounsfield units (percentage of hyperaerated areas) and the 15th percentile (the density value separating the 15% voxels of least density).
RESULTS
A CPAP of 5 cm H(2)O caused little increase in lung aeration in both groups, but in some patients with COPD, CPAP deflated some regions of the lungs. CPAP levels of 10 cm H(2)O and 15 cm H(2)O increased the emphysematous zones in all sectors of the lungs, including dorsal and apical regions in patients with COPD compared to little hyperaeration predominantly in the ventral areas in healthy volunteers.
CONCLUSIONS
Nasal CPAP causes variable effects on regional lung aeration in relation to the applied pressure and the regional distribution of emphysema in patients with COPD. Low pressure levels may cause regional lung deflation in some patients. High levels increase the emphysematous areas wherever they are located inside the lungs.