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Biomedical subjects

M A Schroeder

Publications and source records attributed to M A Schroeder.

At least 19 recordsLinked to original sources

Major influences on maternal responsiveness to infants.

Thirty healthy, middle-class mothers were interviewed during their postpartum hospital stay to identify major influences on mothers' responses to their infants. Sullivan's theorem of tenderness served as a guide for exploring maternal responsiveness. Three major categories, infant tenderness needs, maternal perception, and maternal needs, and their related properties, were described. Support persons were viewed as very important. Mothers also believed that some infant needs were more important than others. Finally, mothers felt that they were constantly faced with priorities, and that the emotional state of the mother and infant often influenced their interaction.

Adult

Regional adaptations of rabbit diaphragm muscle fibers to unilateral denervation.

We hypothesized that adaptations of the rabbit diaphragm (Dia) after unilateral denervation (DNV) result from removal of a neural influence rather than from passive stress. Length changes of midcostal and sternal Dia regions were measured before and after DNV by using sonomicrometry. Midcostal fibers passively lengthened after DNV, whereas sternal fibers shortened. In both regions, these length changes were associated with minimal stress, as estimated from passive force-length relationships. Morphological and contractile adaptions of midcostal and sternal Dia regions were examined after 1 and 4 wk of DNV. In both Dia regions, type I fibers progressively hypertrophied, whereas type IIb fibers atrophied. After DNV, changes in isometric contraction were similar in both Dia regions. Twitch contraction and half-relaxation times increased, force-frequency relationships shifted leftward, and maximum tetanic force decreased. We conclude that passive length changes and mechanical stress are not the main determinants of the morphological and contractile adaptations of the Dia after unilateral DNV but that these adaptations result from DNV itself.

Adaptation, Physiological

Experimental emphysema.

This animal model of emphysema exhibits the same abnormalities in respiratory mechanics as those seen in human emphysema. The histologic and radiographic findings also closely resemble changes of panacinar disease. Moreover, the progressive hypoxemia preceding hypercarbia also parallels the clinical course seen in human disease. Drawbacks of this model include the long time period required to develop significant changes and the cost of maintaining the animals for such a time period. Large cystic areas were not noted in our animals and one would have to turn to another model to address the problem of giant bullous emphysema. There is no ideal animal model of pulmonary emphysema, and the usefulness of an experimental model should be judged on how well it answers the specific questions. Significant information has been obtained using various animal models of emphysema in lung transplantation, diaphragmatic function, pulmonary hemodynamics, and in several other areas. The dog appears to be a suitable model for thoracic surgical research on emphysema.

Animals

Functional significance of expiratory muscles during spontaneous breathing in anesthetized dogs.

Recent electromyographic studies in awake and anesthetized dogs have demonstrated that spontaneous breathing in prone dogs is associated with an increased activation of the expiratory muscles compared with that recorded in supine dogs. On the basis of these observations, one would infer that the mechanical role and contribution of the expiratory musculature to the act of breathing are enhanced in the prone posture. The changes in length associated with these postural increases in expiratory muscle electrical activity, however, have not been investigated and formed the basis of our investigation. We examined the active and passive changes in length of expiratory muscles during spontaneous breathing in supine and prone anesthetized dogs and assessed the relative role of the expiratory musculature in the generation of tidal volume. The experiments were performed on eight mongrel dogs anesthetized with pentobarbital sodium. In all eight animals, spontaneous breathing in the prone posture was associated with an increased activation (electromyogram) of the triangularis sterni, external oblique, and transversus abdominis muscles compared with that recorded in the supine posture. We quantitated the role of the expiratory muscles in both postures by measuring the volume difference between relaxation volume of the respiratory system and the end-expiratory lung volume. In the supine animal, 93 ml were attributed to the expiratory musculature, whereas in the prone animal, we noted that 186 ml (P < 0.01) were displaced during expiration, representing 43 and 52% (NS) of tidal volume, respectively. During spontaneous breathing in the supine or prone posture, all three expiratory muscles underwent significant length changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia

Static lung-lung interactions in unilateral emphysema.

Motivated by the introduction of single-lung transplantation into clinical practice, we compared the static mechanical properties of the respiratory system in six supine dogs before (at baseline) with those after the induction of unilateral emphysema. Relaxation volume (Vrel), total lung capacity (TLC), and static compliance of the emphysematous lung increased to 214 +/- 68, 186 +/- 39, and 253 +/- 95% (SD) of baseline, respectively. Vrel of the nonemphysematous lung fell to 81 +/- 28% of baseline, with no significant change in TLC of the nonemphysematous lung or its pressure-volume relationship, indicating that unilateral hyperinflation does not cause dropout of contralateral lung units. After unilateral emphysema, the chest wall shifted to a higher unstressed or neutral volume (when pleural pressure equals atmospheric pressure) in three of six animals, minimizing the anticipated decrease in lung recoil pressure at the higher respiratory system Vrel. The pattern of relative lung emptying in the intact dog and in the excised lungs was similar during stepwise deflations from TLC, suggesting that mean pleural pressure of the hemithoraces is equal. We conclude that in the dog the static volume distribution between emphysematous and nonemphysematous lungs is determined only by differences in lung recoil and compliance.

Animals

Mechanical role of expiratory muscle recruitment during eupnea in supine anesthetized dogs.

To assess the mechanical role of the expiratory musculature during eupnea, we recorded the electromyographic (EMG) activity of the triangularis sterni, the external oblique, and the transversus abdominis in eight supine lightly anesthetized dogs and have measured the volume generated by the phasic activation of the expiratory muscles. Activation of the expiratory muscles was invariably associated with a decrease in lung volume below the relaxed position of the respiratory system, a volume equal to 41.3 +/- 8.4 ml. This volume represented roughly 20% of tidal volume generated during spontaneous breathing. The fractional expiratory contribution to the tidal volume was unrelated to the size of the animal. Traction on the forelimbs (limb extension), however, tended to enhance the phasic expiratory activation of both the triangularis sterni and the transversus abdominis in the majority of animals. Moreover, after limb extension, the fractional contribution of tidal volume attributed to the phasic activation of the expiratory muscles increased in all but one animal. During spontaneous breathing with the forelimbs extended, roughly 25% of tidal volume was found to be due directly to phasic expiratory muscle contraction. The present observations firmly establish that in supine lightly anesthetized dogs breathing at rest the expiratory component of tidal volume represents a substantial contribution.

Anesthesia

Mechanical role of expiratory muscles during breathing in prone anesthetized dogs.

The purpose of the present study was to assess the mechanical role of the expiratory muscles during spontaneous breathing in prone animals. The electromyographic (EMG) activity of the triangularis sterni, the rectus abdominis, the external oblique, and the transversus abdominis was studied in 10 dogs light anesthetized with pentobarbital sodium. EMGs were recorded during spontaneous steady-state breathing in supine and prone suspended animals both before and after cervical vagotomy. We also measured the end-expiratory lung volume [functional residual capacity (FRC)] in supine and prone positions to assess the mechanical role of expiratory muscle activation in prone dogs. Spontaneous breathing in the prone posture elicited a significant recruitment of the triangularis sterni, the external oblique, and the transversus abdominis (P less than 0.05). Bilateral cervical vagotomy eliminated the postural activation of the external oblique and the transversus abdominis but not the triangularis sterni. Changes in posture during control and after cervical vagotomy were associated with an increase in FRC. However, changes in FRC, on average, were 132.3 +/- 33.8 (SE) ml larger (P less than 0.01) postvagotomy. We conclude that spontaneous breathing in prone anesthetized dogs is associated with a marked phasic expiratory recruitment of rib cage and abdominal muscles. The present data also indicate that by relaxing at end expiration the expiratory muscles of the abdominal region are directly responsible for generating roughly 40% of the tidal volume.

Anesthesia, General

Diagnosing and dealing with multicollinearity.

The purpose of this article was to increase nurse researchers' awareness of the effects of collinear data in developing theoretical models for nursing practice. Collinear data distort the true value of the estimates generated from ordinary least-squares analysis. Theoretical models developed to provide the underpinnings of nursing practice need not be abandoned, however, because they fail to produce consistent estimates over repeated applications. It is also important to realize that multicollinearity is a data problem, not a problem associated with misspecification of a theorectical model. An investigator must first be aware of the problem, and then it is possible to develop an educated solution based on the degree of multicollinearity, theoretical considerations, and sources of error associated with alternative, biased, least-square regression techniques. Decisions based on theoretical and statistical considerations will further the development of theory-based nursing practice.

Humans

Effect of midline laparotomy on the cough reflex in dogs.

The present studies were designed to test the hypothesis that midline laparotomy promotes selective inhibition of the transversus abdominis muscle during cough as it does during expiratory threshold loading. Anesthetized dogs were studied in the supine posture, and cough was induced by mechanical stimulation of the airways. Midline laparotomy had virtually no effect on the cough-induced activation of the triangularis sterni or the external oblique. On the other hand, the activation of the transversus abdominis was markedly reduced in all animals. Despite this marked inhibition, however, peak pleural pressure and expiratory flow were preserved. This suggests that this inhibition does not play a significant role in determining the occurrence of bronchopulmonary infection after abdominal surgery.

Abdominal Muscles

Canine model of chronic bronchial injury. Lung mechanics and pathologic changes.

Bronchial injury was induced in 7 dogs by exposure to nebulized 1% nitric acid 3 days per week for 4 weeks. Lung mechanics were measured prior to exposure, at the completion of exposure, and at 1, 3, and 5 months postexposure. Airway obstruction persisted unabated throughout the postexposure period, with significant reductions in maximal expiratory flows. Pulmonary resistance, the slope of phase III, and the volume of isoflow were increased. Hyperresponsiveness to histamine developed between 3 and 5 months. Histologically, there was minimal damage to the cartilaginous airways. Widespread chronic inflammation with minimal fibrosis was seen in the membranous bronchi and respiratory bronchioles. Pathology scores for cartilaginous and noncartilaginous (small) airways were developed and correlated with tests of airway function. Small airways pathology scores correlated with flows at 50 and 25% of the vital capacity and with pulmonary resistance. Density dependence of maximal expiratory flow, closing volume, and closing capacity failed to correlate with either the airway obstruction or the small airways pathology scores.

Animals

Evaluation of the contribution of tannin to the acute pulmonary inflammatory response against inhaled cotton mill dust.

Anesthetized, intubated, and mechanically ventilated rabbits were exposed to aerosolized saline, cotton dust extract (CDE), or tannin for 5 minutes and lavaged 4 hours after exposure. Cell numbers and types present in the bronchoalveolar lavage fluid (BALF) were determined and the concentrations of thromboxane A2 (TxA2) and prostaglandin F2-alpha (PGF2-alpha) in the BALF were also analyzed. The saline control animals had increased numbers and percentage of polymorphonuclear leukocytes (PMN) in the BALF as well as increased levels of TxB2 and PGF2-alpha compared with unexposed animals. Exposure to CDE further increased the number and percentage of PMN and the level of PGF2-alpha but had no effect on TxA2 levels when compared with control animals. Tannin exposure increased PGF2-alpha levels to the same extent as CDE exposure. PMN also increased but to a lesser extent than with CDE. These results indicate that the inflammatory response to CDE is only partially due to the tannin present in CDE.

Animals

Development of a Database Management System for an obstetrics unit.

This article discusses the use of computer technology in expediting and simplifying the retrieval of data generated from clinical practice. The article describes the collaboration between academic faculty and nurse clinicians in developing a computerized database to report birth statistics incurred by a busy obstetrical unit. A secondary purpose of the article is to assist the reader in understanding the importance of planning the content to be entered into the database and to become familiar with the basics of developing a database that could be used to sort and retrieve data. Facilitators and barriers to the development of a database management system in clinical practice are also discussed.

Database Management Systems