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Biomedical subjects

J D Road

Publications and source records attributed to J D Road.

At least 37 records · Page 2Linked to original sources
PubMed1994

Regional diaphragm shortening measured by sonomicrometry.

Diaphragmatic shortening measured by sonomicrometry has been compared in the two major anatomic segments, costal and crural. Data obtained by videofluoroscopy found a variation in subsegmental shortening within segments (Sprung et al. J. Appl. Physiol. 67: 655-662, 1989). No reproducible pattern of subsegmental shortening has emerged, and the mechanisms leading to this subsegmental variation in shortening are unknown. Therefore, we compared subsegmental shortening in both segments of the diaphragm in seven supine pentobarbital-anesthetized dogs. Seven pairs of sonomicrometer transducers were implanted in the two segments, and subsegmental shortening during spontaneous breathing was measured. To determine potential mechanisms contributing to the variation in shortening, measurements were made during stimulated breathing, after epiphrenic stimulation, and during occluded breaths. We found electrical stimulation at physiological frequencies of 10 and 20 Hz reduced the variation in subsegmental shortening, whereas stimulated breathing did not. Occluded breaths showed a consistent decrease in the amount of shortening, particularly in the dome of the costal diaphragm, compared with shortening in the area of apposition. Comparison of shortening between segments revealed greater crural than costal shortening. We conclude that subsegmental variation in activation can contribute to variation in subsegmental shortening and that the afterload can effect shortening during occluded breaths.

Animals↗
PubMed1993

Abdominal muscle activation by expiratory threshold loading in awake dogs.

Abdominal muscle activation produced by expiratory threshold loading (ETL) helps prevent an increase in FRC thus, optimizing diaphragm length and defending VT. However, anesthesia may affect abdominal muscle activation, and the pattern of recruitment and level of activation of individual abdominal muscles may well be dependent on body position. Therefore, individual abdominal muscle response to ETL was assessed in awake dogs, lying in the lateral decubitus position. Eight, tracheotomized dogs were chronically instrumented with sonomicrometer transducers and bipolar, fine wire EMG electrodes, in each of the four abdominal muscles. ETL produced increases in active, expiratory shortening of the transversus abdominis (TA), internal oblique (IO) and external oblique (EO). In addition, tonic activity, assessed from a decrease in baseline length, increased in the IO. There was a significant increase in FRC during ETL but it was less than would be expected without tonic and phasic abdominal muscle activation. Although FRC increased, VT and breathing frequency were maintained. As was found previously in supine, anesthetized dogs, the internal abdominal muscle layer (TA and IO) was recruited preferentially; substantiating its greater role in the defence of lung volume.

Abdominal Muscles↗
PubMed1993

Delayed poststimulus decrease of phrenic motoneuron output produced by phrenic nerve afferent stimulation.

The immediate effects of phrenic afferent nerve activation on ventilation have been shown to be both excitatory and inhibitory. Long-lasting inhibitory effects on respiratory motoneuron output have been reported after stimulation of afferent nerves from limb muscles. However, whether respiratory muscle afferent nerves can produce this effect is unknown. We therefore hypothesized that activation of phrenic afferent nerves may produce a prolonged decrease of respiratory motoneuron output. Six alpha-chloralose-anesthetized dogs were studied after vagotomy and bilateral carotid sinus nerve section. The dogs were paralyzed, and end-tidal CO2 was controlled by mechanical ventilation. The proximal end of the cut thoracic phrenic nerve was electrically stimulated for 1 min at intensities that produced activation of thin-fiber afferents. The contralateral efferent phrenic integrated electroneurogram (ENG) was recorded. During stimulation, phrenic ENG activity increased. ENG activity was recorded during recovery and reached a peak decrease compared with control of 19 +/- 11% (SD) 9.0 +/- 6 min after stimulation and returned to control after 30 min. A qualitatively similar response was seen after stimulation of the gastrocnemius nerve. We conclude that activation of thin-fiber afferents in the phrenic nerve can produce a delayed and prolonged decrease of respiratory motoneuron output similar to that of limb muscle afferent nerves.

Anesthesia↗
PubMed1993

Effects of posture on abdominal muscle shortening in awake dogs.

The objective of this study was to examine the effects of posture on tonic and phasic expiratory activity of the abdominal muscles in awake dogs. Six tracheostomized dogs were chronically instrumented with sonomicrometer transducers and bipolar electromyographic electrodes placed in each of the four abdominal muscles. To determine the effects of posture on tonic and phasic activity of individual abdominal muscles, muscle resting length (Lr) and tidal length changes (%Lr), respectively, were measured in awake dogs in the left lateral decubitus (LLD), sitting, and standing (STAND) positions. The transversus abdominis Lr consistently shortened when the dog was moved from LLD to STAND and lengthened when the dog was moved from LLD to the sitting position, and the external oblique Lr consistently lengthened when the dog went from LLD to STAND. The internal oblique and rectus abdominis had no consistent changes in Lr with a change in position. All four abdominal muscles actively shortened (%Lr) more in the upright positions. In addition, the internal layer (transversus abdominis and internal oblique) actively shortened more than the external layer (rectus abdominis and external oblique). In conclusion, both tonic and phasic respiratory activity of the abdominal muscles, reflected by changes in Lr and %Lr, respectively, were affected by changes in posture.

Abdominal Muscles↗
PubMed1993

Energy balance in stable malnourished patients with chronic obstructive pulmonary disease.

We have measured caloric intake, energy expenditure, and the thermogenic effect of food in ten patients with stable COPD who had a history of involuntary weight loss over several years and were malnourished (< 85 percent ideal body weight). Each patient completed a 7-day food record. Indirect calorimetry was performed in the resting postabsorptive state. After placement of a nasoenteric tube, patients were randomly assigned to be refed or sham-fed (mean +/- SD, 16 +/- 3 days), following which, metabolic measurements were repeated. Indirect calorimetry was also performed before and after a large meal in each patient. Home caloric intake was 135 +/- 23 percent of resting energy expenditure. Resting energy expenditure was 94 +/- 16 percent of that predicted by the Harris-Benedict equation and did not change significantly during inpatient refeeding. Refeeding resulted in weight gain (2.4 +/- 1.9 kg, p < 0.02). A large meal caused substantial increases in energy expenditure (24 +/- 18 percent), carbon dioxide production (39 +/- 18 percent), and oxygen consumption (23 +/- 16 percent). We conclude that stable malnourished COPD patients consume adequate calories to meet average energy requirements and are not hypermetabolic. Inpatient refeeding by nocturnal nasoenteric infusion is well tolerated and results in weight gain, but the thermogenic effect of a large meal poses a considerable metabolic and ventilatory load that could precipitate acute respiratory failure.

Aged↗
PubMed1992

Expiratory muscle activity in the awake and sleeping human during lung inflation and hypercapnia.

Expiratory muscle activity has been shown to occur in awake humans during lung inflation; however, whether this activity is dependent on consciousness is unclear. Therefore we measured abdominal muscle electromyograms (intramuscular electrodes) in 13 subjects studied in the supine position during wakefulness and non-rapid-eye-movement sleep. Lung inflation was produced by nasal continuous positive airway pressure (CPAP). CPAP at 10-15 cmH2O produced phasic expiratory activity in two subjects during wakefulness but produced no activity in any subject during sleep. During sleep, CPAP to 15 cmH2O increased lung volume by 1,260 +/- 215 (SE) ml, but there was no change in minute ventilation. The ventilatory threshold at which phasic abdominal muscle activity was first recorded during hypercapnia was 10.3 +/- 1.1 l/min while awake and 13.8 +/- 1 l/min while asleep (P less than 0.05). Higher lung volumes reduced the threshold for abdominal muscle recruitment during hypercapnia. We conclude that lung inflation alone over the range that we studied does not alter ventilation or produce recruitment of the abdominal muscles in sleeping humans. The internal oblique and transversus abdominis are activated at a lower ventilatory threshold during hypercapnia, and this activation is influenced by state and lung volume.

Abdominal Muscles↗
PubMed1992

Effect of vagal stimulation and parenteral acetylcholine on canine trachealis muscle shortening.

Canine trachealis smooth muscle shortening (TMS) in response to vagal nerve stimulation is approximately 30%, far less than the 70% predicted from in vitro studies. We hypothesized that in vivo airway smooth muscle activation during vagal stimulation may be submaximal, and in this study we wished to determine TMS during maximal activation. TMS was studied in 12 alpha-chloralose-anesthetized dogs during vagal stimulation, systemic acetylcholine injection, and local acetylcholine injection. Bilateral vagal stimulation produced TMS of 26 +/- 5% (SE) length at functional residual capacity (LFRC). Maximal TMS during systemic injection of acetylcholine was 28 +/- 12% LFRC but may have been limited by delivery of acetylcholine to the muscle because asystole occurred at higher concentrations. TMS was greatest during local injection of acetylcholine (48 +/- 7% LFRC). There was a greater increase in pulmonary resistance and decrease in dynamic compliance during systemic acetylcholine injection than during vagal stimulation. We conclude that bilateral vagal nerve stimulation does not maximally activate trachealis smooth muscle but that the maximal shortening achieved with local injection of acetylcholine is still less than isotonic shortening in vitro. These data suggest that maximal shortening in vivo is limited by the afterload provided by the tracheal cartilaginous rings.

Acetylcholine↗
PubMed1992

Ventilatory dysfunction in severe anorexia nervosa.

A 25-year-old woman suffering from chronic anorexia nervosa lost more than 50 percent of her body weight and presented with generalized muscle weakness. Pulmonary function tests showed a severe restrictive defect, and she had marked impairment of respiratory muscle strength and endurance, peripheral muscle function, and hypercapnic ventilatory responses, all of which improved following refeeding. The interaction and response to treatment of these effects on respiratory function are discussed.

Adult↗
PubMed1992

The effect of salbutamol on performance in elite nonasthmatic athletes.

The effect of salbutamol on performance was studied in seven male nonasthmatic highly trained (VO2max > or = 60 ml.kg-1 x min-1) cyclists. Salbutamol (S = 2 puffs = 200 micrograms) or placebo (P) was administered by metered-dose inhaler, through a spacer device, 20 min prior to testing in a double-blind, randomized cross-over design. Testing sessions on a cycle ergometer included the measurement of maximal oxygen uptake (VO2max), peak power, maximal heart rate, and pulmonary function. A timed sprint to exhaustion was performed after 45 min of exercise at 70% of VO2max, and a Wingate anaerobic test was used to measure total work and peak power. There was a nonsignificant decrease in VO2max (P = 63.5 +/- 3.2; S = 62.6 +/- 3.3 ml.kg-1 x min-1). No difference was found in peak power, maximum heart rate, endurance sprint time, Wingate peak power, or total work. After an anticipated baseline increase was taken into account, the pattern of change in FEV1 over time did not differ between salbutamol and placebo. It was concluded that a therapeutic dose of aerosol salbutamol does not have an ergogenic effect in elite nonasthmatic athletes, and it is therefore recommended that inhaled salbutamol continue to be permitted in international competition for individuals with exercise induced bronchospasm.

Albuterol↗
PubMed1991

Effect of lung inflation and upright posture on diaphragmatic shortening in dogs.

In an earlier study (Road and Leevers (1988), J. Appl. Physiol. 65: 2283-2389), the application of continuous positive airway pressure (CPAP) produced a marked reduction in diaphragm initial length (LFRC) and tidal diaphragmatic shortening (%LFRC), tidal volume (VT) and transdiaphragmatic pressure swings (delta Pdi) in supine dogs after vagotomy. We postulated that the reduced diaphragmatic shortening was mainly a result of the decrease in diaphragm LFRC but an increase in afterload could not be excluded. In this study, we attempted to define the role of these two mechanisms during postural change. Eight, pentobarbital-anaesthetized, vagotomized dogs were studied in the supine position during CPAP and during postural change (tilting towards upright). As before, CPAP produced a prompt reduction in diaphragm LFRC and tidal %LFRC, VT and delta Pdi. Tilting produced similar decreases in crural diaphragm LFRC (23% from control values) as the weight of the abdominal contents was removed, but less decrease in costal LFRC (17% during CPAP compared to 10% during tilting). A given reduction in crural diaphragm initial length (15%) resulted in less tidal shortening during tilting compared to CPAP, whereas costal diaphragm shortening was similar at a given reduction in initial length (10%). Both CPAP and tilting reduced tidal volumes (47.8 +/- 5.1 and 56.5 +/- 3.1% of control), however, delta Pdi decreased less during tilting (20%) than CPAP (47%). There was no significant change in the level of diaphragmatic EMG with either CPAP or tilting.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Respiratory muscle coordination and diaphragm length during expiratory threshold loading.

Active expiration is produced by the abdominal muscles and the rib cage expiratory muscles. We hypothesized that the relative contribution of these two groups to expiration would affect diaphragmatic length and, hence, influence the subsequent inspiration. To address this question we measured the respiratory muscle response to expiratory threshold loading in spontaneously breathing anesthetized dogs. Prevagotomy, the increase in lung volume (functional residual capacity) and decrease in initial resting length of the diaphragm were attenuated by greater than 50% of values predicted by the passive relationships. Diaphragmatic activation (electromyogram) increased and tidal volume (VT) was preserved. Postvagotomy, effective expiratory muscle recruitment was abolished. The triangularis sterni muscle remained active, and the increase in lung volume was attenuated by less than 15% of that predicted by the passive relationship. Diaphragmatic length was shorter than predicted. VT was not restored, even though costal diaphragmatic and parasternal intercostal electromyogram increased. During expiratory threshold loading with abdominal muscles resected and vagus intact, recruitment of the rib cage expiratory muscles produced a reduction in lung volume comparable with prevagotomy; however, diaphragmatic length decreased markedly. Both the rib cage and abdominal expiratory muscles may defend lung volume; however, their combined action is important to restore diaphragmatic initial length and, accordingly, to preserve VT.

Animals↗
PubMed1991

Pulmonary function in individuals with a history of poliomyelitis.

We examined the relationship between the lung function of 74 individuals with a history of poliomyelitis and reports of shortness of breath during activities of daily living, and the presence of post-polio sequelae risk factors. First, we studied the spirometry of 60 individuals (group 1) and second, we studied the relationship between the spirometry of an additional 14 individuals (group 2) and their respiratory muscle strength (Pimax and Pemax). In both groups, we examined the relationship between factors associated with post-polio sequelae including ventilation at polio-onset, having contracted polio after the age of 10, and having had polio for over 35 years; and lung function. In group 1, the FEV1 and FVC were lower for individuals with shortness of breath than individuals without (p less than 0.01). With respect to risk factors, FEV1 and FVC were lower in individuals who were ventilated at polio-onset, in individuals who contracted polio over 10 years of age, and in individuals who had had polio for less, rather than more than 35 years (p less than 0.05). The results for group 2 were comparable to group 1. In addition, the observed Pimax and Pemax were significantly lower than predicted values (p less than 0.05). Although FEV1 and FVC were positively correlated with both Pimax and Pemax (p less than 0.05), Pemax was disproportionately impaired compared to Pimax (40 +/- 12.1 and 82 +/- 38.8 percent predicted respectively). We conclude that individuals with a history of poliomyelitis can have compromised lung function irrespective of shortness of breath, that risk factors such as ventilation at polio-onset and polio-onset after 10 years of age can help predict those at risk of respiratory compromise, and that the measurement of respiratory muscle strength and of Pemax in particular, can augment the assessment of lung function of these individuals. Such assessment may avert respiratory complications in the post poliomyelitis population including those secondary to health care interventions.

Adult↗
PubMed1990

Phrenic afferents and ventilatory control.

It has been understood since the late 1800s that the diaphragm has significant sensory innervation. The role of phrenic afferents in the control of breathing, however, has been obscure. The phrenic nerve has been shown to contain a full array of afferent fibers. However, proprioceptive (group 1 fibers) afferents are few compared to postural muscles or the intercostals. The diaphragm, unlike the inspiratory intercostal muscles, has a small complement of spindle afferents and not all of these spindles are supplied with fusorial fibers. Reduced spindle afferents under gamma control help to explain previous studies of the diaphragm that have failed to reveal autogenic facilitation, that is, a reflex-mediated increase in drive during inspiratory loading. Nevertheless, some clinical studies have revealed increased activation of the diaphragm when its length is reduced. Group 1 fibers, which are predominantly tendon organ afferents in the diaphragm, have been shown to have a phasic inhibitory function. A reduction in this inhibition brought about by a reduction in diaphragmatic length during lung inflation may explain the increased diaphragmatic activation reported in clinical studies. Phrenic afferents have been shown to have multiple spinal and supraspinal projections. Recent studies have explored the ventilatory effects of thin fiber afferents (group III and IV fibers) in the phrenic nerve. Stimulation of these afferents has been shown both to inhibit and excite ventilation. These afferents arise from polymodal receptors that respond to both mechanical and chemical stimulation. Activation of these receptors may occur in a variety of conditions and the ventilatory response may be determined by the specific receptor activated.

Animals↗
PubMed1990

Inspiratory and expiratory muscle function during continuous positive airway pressure in dogs.

Continuous positive airway pressure (CPAP) is known to produce activation of the expiratory muscles. Several factors may determine whether this activation can assist inspiration. In this study we asked how and to what extent expiratory muscle contraction can assist inspiration during CPAP. Respiratory muscle response to CPAP was studied in eight supine anesthetized dogs. Lung volume and diaphragmatic initial length were defended by recruitment of the expiratory muscles. At the maximum CPAP of 18 cmH2O, diaphragmatic initial lengths were longer than predicted by the passive relationship by 52 and 46% in the costal and crural diaphragmatic segments, respectively. During tidal breathing after cessation of expiratory muscle activity, a component of passive inspiration occurred before the onset of inspiratory diaphragmatic electromyogram (EMG). At CPAP of 18 cmH2O, passive inspiration represented 24% of the tidal volume (VT) and tidal breathing was within the relaxation characteristic. Diaphragmatic EMG decreased at CPAP of 18 cmH2O; however, VT and tidal shortening were unchanged. We identified passive and active components of inspiration. Passive inspiration was limited by the time between the cessation of expiratory activity and the onset of inspiratory activity. We conclude that increased expiratory activity during CPAP defends diaphragmatic initial length, assists inspiration, and preserves VT. Even though breathing appeared to be an expiratory act, there remained a significant component of active inspiratory diaphragmatic shortening, and the major portion of VT was produced during active inspiration.

Abdominal Muscles↗
PubMed1990

The effects of refeeding on peripheral and respiratory muscle function in malnourished chronic obstructive pulmonary disease patients.

We carried out a prospective randomized controlled trial to investigate the effects of short-term refeeding (16 days) in 10 malnourished inpatients with chronic obstructive pulmonary disease (COPD). Six patients were randomized to receive sufficient nasoenterically administered calories to provide a total caloric intake equal to 1,000 kcal above their usual intake. The other four patients were sham fed, receiving only 100 kcal more. Measurements of nutritional status, respiratory muscle strength and endurance, adductor pollicis function, and pulmonary function were performed initially and at study end. The refed group gained significantly more weight and showed significant increases in maximal expiratory pressure and mean sustained inspiratory pressure. There were no significant changes in the maximal inspiratory pressure or in adductor pollicis function. In malnourished inpatients with COPD, short-term refeeding leads to improvement in respiratory muscle endurance and in some parameters of respiratory muscle strength in the absence of demonstrable changes in peripheral muscle function.

Aged↗
PubMed1990

Respiratory muscle function during obstructive sleep apnea.

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction during sleep. Inspiratory muscles may be subjected to potentially fatiguing loads during an obstructive apnea and this may be related to the termination of obstructive apnea. We have measured transdiaphragmatic pressure (Pdi) and breathing patterns in six male patients with OSA during sleep to characterize respiratory muscle function in OSA and determine whether apnea termination is consistently related to a pressure time index of the diaphragm (PTI) associated with respiratory muscle fatigue. There was a large intersubject variability in Pdi generation during apnea. No consistent level of PTI was associated with apnea termination. During prolonged apneas, the respiratory duty cycle plateaued, which is suggestive of an inhibitory reflex possibly mediated by chest wall afferents. There were intersubject differences in both inspiratory and expiratory muscle recruitment during apnea. In the majority of patients, the diaphragm appeared to be the primary inspiratory muscle during apnea, but in some it appeared to be the intercostal/accessory muscles. The majority of patients demonstrated an increase in gastric pressure and inward abdominal movement during the expiratory phases of an apnea, consistent with abdominal muscle recruitment stimulated by increased ventilatory drive.

Diaphragm↗
PubMed1989

Mechanical response to hyperinflation of the two abdominal muscle layers.

Abdominal muscle length changes and activity were directly examined in vivo with the use of the techniques of sonomicrometry and electromyography, respectively, in nine supine anesthetized dogs. Expiratory threshold loading was utilized to stimulate recruitment of the abdominal muscles, and lung inflations produced the passive relationships. The internal layer, consisting of the internal oblique and transversus abdominis, shortened more in expiration than the external layer, consisting of the external oblique and rectus abdominis. The internal oblique shortened to approximately 83% of its length at functional residual capacity vs. 98% for the external oblique (P less than 0.05). The results obtained during passive lung inflation indicate these internal muscles are also more influenced by changes in lung volume. The internal oblique lengthened to 115% of its length at functional residual capacity vs. 103% for external oblique at total lung capacity (P less than 0.05). The results suggest that anatomic division of the abdominal muscles into external and internal layers corresponds to functional differences in terms of both passive lengthening and active shortening during ventilation and that these differences imply variable functions of the two layers.

Abdominal Muscles↗