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F D McCool

Publications and source records attributed to F D McCool.

43 records · Page 3Linked to original sources

Pressure-flow effects on endurance of inspiratory muscles.

We examined the effects of varying inspiratory pressures and flows on inspiratory muscle endurance. Four normal subjects performed voluntary forced breathing with various assigned inspiratory tasks. Duty cycle, tidal volume, and mean lung volume were the same in all tasks. Mean esophageal pressure, analogous to a pressure-time integral (PTes), was varied over a wide range. In each task the subject maintained an assigned PTes while breathing on one of a range of inspiratory resistors, and this gave a range of inspiratory flows at any given PTes. Inspiratory muscle endurance for each task was assessed by the length of time the task could be maintained (Tlim). For a given resistor, Tlim increased as PTes decreased. At a given PTes, Tlim increased as the external resistance increased and therefore as mean inspiratory flow rate (VI) decreased. Furthermore, for a given Tlim, PTes and VI were linearly related with a negative slope. We conclude that inspiratory flow, probably because of its relationship to the velocity of muscle shortening, is an independent variable importantly influencing endurance of the inspiratory muscles.

Adult↗

Mean airway opening pressure as an index of inspiratory muscle task intensity.

The relationship between mean values of pressure (pressure-time integral including both inspiration and expiration) measured at the airway opening (Pao) and in the esophagus (Pes) is described for ventilation on a variety of external inspiratory resistances. Pao/Pes was 0.85 or greater when the external inspiratory resistance was a 4.0-mm or smaller endotracheal tube adaptor. Additionally, Pao can be easily and accurately measured by a slowly responding mechanical manometer. This device is simple in design, unpowered, inexpensive, and can be used outside the laboratory as part of an inspiratory muscle training program.

Esophagus↗

Changes in lung volume and rib cage configuration with abdominal binding in quadriplegia.

Previous studies suggest that abdominal binding may affect the interaction of the rib cage and the diaphragm over the tidal range of breathing in quadriplegia. To determine whether abdominal binding influences rib cage motion over the entire range of inspiratory capacity, we used spirometry and the helium-dilution technique to measure functional residual capacity (FRC), inspiratory capacity, and total lung capacity (TLC) in eight quadriplegic and five normal subjects in supine, tilted (37 degrees), and seated positions. Combined data in all three positions indicated that, with abdominal binding, FRC and TLC decreased in normal subjects [delta FRC = -0.33 + 0.151 (SD) P less than 0.01); delta TLC = -0.16 + 0.121, P less than 0.05]. In quadriplegia there was also a reduction in FRC with binding (delta FRC = -0.32 + 0.101, P less than 0.001). However, TLC increased in quadriplegia (delta TLC = 0.07 + 0.061, P less than 0.025). In an additional six quadriplegic and five normal subjects, we used magnetometers to define the influences of abdominal binding on rib cage dimensions and TLC. In quadriplegia, rib cage dimensions were increased at TLC with abdominal binding, whereas there was no change in normals. Our data suggest that this inspiratory effect of abdominal binding on augmenting rib cage volume in quadriplegia is greater than the effect of impeding diaphragm descent, and thus abdominal binding produces a net increase in TLC in quadriplegia.

Abdomen↗

Estimates of ventilation from body surface measurements in unrestrained subjects.

To make estimates of ventilation from measurements of body surface movements in unrestrained subjects, we measured changes in linear dimensions and cross-sectional areas of the rib cage (RC) and abdomen (AB) of six healthy unrestrained subjects during a variety of maneuvers. RC and AB anteroposterior diameters and abdominal length in the cephalocaudal axis (axial displacement) were measured with magnetometers, and RC and AB cross-sectional areas were measured with a respiratory inductance plethysmograph. Flow was measured at the mouth with a pneumotachograph and integrated electrically to give volume. Volume and body surface measurements were analyzed by multiple linear regression. Addition of the axial measurements to either the anteroposterior dimensions or cross-sectional areas of RC and AB improved estimates of tidal volume in all subjects (P less than 0.01). With measurements of axial displacement and cross-sectional area of the RC and AB, tidal volume could be reliably estimated to within 20% of actual ventilation. We conclude that measurement of axial displacements improves estimates of ventilation in unrestrained subjects.

Abdomen↗

Intermittent positive pressure breathing in patients with respiratory muscle weakness. Alterations in total respiratory system compliance.

Intermittent positive pressure ventilation (IPPB) is reported to improve lung compliance and decrease the work of breathing in subjects with kyphoscoliosis. These results suggest that IPPB may improve chest wall and lung compliance in patients with neuromuscular disease. We studied the short-term effects of IPPB on total respiratory system compliance in 14 subjects with neuromuscular disease. Seven were quadriplegics, and seven had muscular dystrophy. Vital capacity was reduced to 38 +/- 14 percent of the predicted normal values. Baseline measurements of total respiratory system compliance were 57 +/- 18 percent when compared to normal control values. After a 20 minute treatment of IPPB delivered with inspiratory pressures of 20 to 25 cm H2O that more than tripled resting tidal volume, there was no significant change in total respiratory system compliance in either group of patients. These findings indicate that patients with quadriplegia or muscular dystrophy do not derive immediate improvement in ventilatory mechanics from IPPB treatments.

Adolescent↗

Rib cage distortion during voluntary and involuntary breathing acts.

We examined chest wall and rib cage configuration in seven normal subjects during a variety of breathing maneuvers. Magnetometers were used to measure lower rib cage anteroposterior, lower rib cage transverse, upper rib cage anteroposterior, and abdomen anteroposterior diameters. Changes of these diameters were recorded during voluntary maneuvers, rebreathing, reading, and "natural" breathing. Relative motion of the rib cage and abdomen was displayed with the rib cage represented by the product of its lower anteroposterior and transverse diameters. During spontaneous breathing the rib cage and chest wall are near their relaxation configuration. During chemically driven ventilation the chest wall and rib cage progressively depart from this configuration. Much greater distortions of the chest wall and rib cage occurred during some voluntary maneuvers. Additionally, esophageal pressure and gastric pressure were measured during voluntary distortion of the rib cage. Substantial changes in lower rib cage shape occurred during voluntary maneuvers when compared with spontaneous breaths at the same transmural pressure. We conclude that the unitary behavior of the rib cage in normal subjects requires muscle coordination.

Abdominal Muscles↗

Effect of ethanol on ion transport and electrical properties of dog trachea in vitro.

We studied the effect of ethanol on the electrical and ion transport properties of dog tracheal epithelium using Ussing's short-circuit technique. There was a significant reduction of short-circuit current and electrical potential difference and a tendency of electrical resistance to increase in response to increasing concentrations of ethanol in the bathing solutions. Threshold changes in the electrical properties were noted at an ethanol concentration of 3.3 microliter/ml (260 mg/100 ml). Ethanol did not produce these changes in electrical properties when Cl- and Na+ were substituted in the bathing media with either choline or SO2-(4). In five paired tissue preparations, ethanol (13.3 microliters/ml) significantly reduced the net flux of Cl- toward the lumen from 2.68 +/- 0.62 to 1.00 +/- 0.69 (SE) mu eq X cm-2 X h-1, due primarily to a reduced unidirectional flux of Cl- from submucosa to lumen. These observations demonstrate that ethanol has an effect on the ion transport and electrical properties of dog tracheal epithelium at concentrations that may be of clinical relevance.

Animals↗