Nursing professor secures first such award for College of Education and Health Professions to study ways to delay diaphragm fatigue

FAYETTEVILLE, Ark. — Nan Smith-Blair, assistant professor in the University of Arkansas Eleanor Mann School of Nursing, has won a National Institutes of Health grant of $200,000 to fund work that could improve the lives of patients with emphysema.

Smith-Blair will continue her research focusing on the effects of exercise on diaphragm fatigue. Initially funded by the Arkansas Biological Institute, which administers the state’s tobacco settlement funds, the research holds the potential to reduce patient suffering along with cost and length of stay in the hospital. Smith-Blair’s new research funded by the two-year NIH grant will incorporate the use of dobutamine, a drug that improves cardiac output and is used primarily for congestive heart failure.

Reed Greenwood, dean of the College of Education and Health Professions, noted the grant is the first from the National Institutes of Health for the college and supports an interdisciplinary approach.

“This grant confirms that Dr. Smith-Blair and her colleagues are conducting valuable research that can greatly affect the lives of people we know,” Greenwood said. “It facilitates another opportunity for faculty members and students in the college to serve the people of this state and beyond. Three academic departments within our college have joined with a representative of another college to build a team that can delve into several aspects of the research question.”

The NIH is the premier federal funding agency of health related research, and competition is strong for awards. Smith-Blair’s funding came through the agency’s Academic Research Enhancement Award program. It is part of the agency’s effort to stimulate research in educational institutions that provide baccalaureate or advanced training for a significant number of the nation’s research scientists but that have not been major recipients of NIH support.

“This research is geared toward keeping the emphysema patient off a ventilator or more easily weaning the patient off a ventilator,” Smith-Blair said.

Her previous research showed that exercise can help the diaphragm maintain ability to contract properly. This major muscle used for respiration is normally a dome shape that contracts to pull air into the lungs. In patients with emphysema, the muscle is flattened and that contractility — or ability to contract — is restricted.

“It was remarkable,” Smith-Blair said of findings from her initial studies. “Exercise really does help, but for some people exercise can be difficult. It also can be very hard to get off a ventilator.”

The new study will continue to look at how exercise can prevent diaphragm fatigue as well as whether dobutamine can delay the onset of diaphragm fatigue.

Co-investigators on the grant project are Charles Riggs, professor of kinesiology, and Sean Mulvenon, professor of educational statistics, both in the College of Education and Health Professions, and Walter Bottje, head of the poultry science department in the Bumpers College of Agricultural, Food and Life Sciences.

Riggs and one of his doctoral students will assist with measurement of mitochondrial function, an indicator of stress at the cellular level.

“We work in the area of exercise and its impact on disease process, and this grant provides a great opportunity for study,” Riggs said.

Also involved in the research are graduate students and nursing honors students, including Jennifer Bearden, who won a State Undergraduate Research Fellowship this year. Bearden’s component of the research focuses on blood flow.

Mulvenon will serve as statistician for the data analysis portion of the project. He began a 13-month appointment in December as a senior adviser to the deputy secretary of the U.S. Department of Education.

Bottje will assist in mitochondrial analysis to examine oxidative stress at the cellular level. He opened space in a lab for Smith-Blair before she began conducting research with Riggs in the Human Performance Laboratory at the Health, Physical Education and Recreation Building.

Smith-Blair holds a doctoral degree from the University of Kansas School of Nursing, a master’s degree in nursing from Northwestern State University and a bachelor’s degree in nursing from Texas Christian University. She has taught at the University of Arkansas since 1992. She has 30 years of critical-care nursing experience with neonatal, pediatric and adult patients in addition to transport nursing and administrative experience.

“This is one more step in building a research agenda,” Smith-Blair said. “It feels wonderful to see the work pay off, enabling me to continue to research ways to help people. And I have a super team working with me. I couldn’t ask for more highly qualified people.”