Research Topics
| N R MacIntyreSummaryAffiliation: Duke University Medical Center Country: USA Publications
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Detail Information
Publications
Oxygen therapy and exercise response in lung diseaseN R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 45:194-200; discussion 201-3. 2000....- Long-term oxygen therapy: conference summaryN R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 45:237-45. 2000..These kinds of industry-profession collaborations benefit everyone. Finally, I'd like to extend my congratulations to all the speakers for jobs well done and to thank them for making my job as summarizer an enjoyable one... - Chronic obstructive pulmonary disease management: the evidence baseN R MacIntyre
Respiratory Care Services, Duke University Medical Center, PO Box 3111, Durham, NC 27710, USA
Respir Care 46:1294-303. 2001..Moreover, routine antibiotic use seems beneficial, and the role of noninvasive positive-pressure ventilation with patients suffering impending respiratory failure from acute COPD exacerbations is well supported by the literature... - High-frequency jet ventilationN R MacIntyre
Department of Pulmonary and Critical Care, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care Clin N Am 7:599-610. 2001..g., selected neonates, adult airway surgical procedures) and to centers skilled in its use. Considerably more data are required before extensive application, especially in the adult, is warranted... - Current issues in mechanical ventilation for respiratory failureNeil R MacIntyre
Pulmonary and Critical Care Medicine, Duke University Medical Center, Room 7453 Duke Hospital, Box 3911 Medical Center, Durham, NC 27710, USA
Chest 128:561S-567S. 2005..These efforts involve the initiation of spontaneous-breathing trials, implementation of systematic weaning protocols, and optimization of individual patient interventions... - Evidence-based assessments in the ventilator discontinuation processNeil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 57:1611-8. 2012..Nevertheless, there is still room for improvement and need for further clinical studies, especially in the patient requiring prolonged mechanical ventilation... 
Chronic critical illness: the growing challenge to health careNeil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 57:1021-7. 2012..Management of the CCI population requires a special combination of intensive care and rehabilitative skills...- Pulmonary function testing: coding and billing issuesNeil R MacIntyre
Pulmonary Function Laboratory, Department of Medicine, Duke University Medical Center, Durham NC 27710, USA
Respir Care 48:786-90. 2003.... - Is there a best way to set positive expiratory-end pressure for mechanical ventilatory support in acute lung injury?Neil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Box 3911, Room 1120, Erwin Road, Durham, NC 27710, USA
Clin Chest Med 29:233-9, v. 2008..Positive expiratory-end pressure is a widely used technique to maintain alveolar patency, but its beneficial effects must be balanced against its harmful effects... - Is there a best way to set tidal volume for mechanical ventilatory support?Neil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Room 1120, Box 3911, Erwin Road, Durham, NC 27710, USA
Clin Chest Med 29:225-31, v. 2008..Clinical trials have shown that limiting maximal and tidal stretch improves outcomes, even if gas exchange is partially compromised. Thus, current strategies should focus on limiting tidal and maximal stretch as much as possible... - Evidence-based ventilator weaning and discontinuationNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham NC 27710, USA
Respir Care 49:830-6. 2004..5. Ventilator-discontinuation and weaning protocols can be effectively carried out by nonphysician clinicians... - Discontinuing mechanical ventilatory supportNeil MacIntyre
Duke University Medical Center, Durham, NC 27710, USA
Chest 132:1049-56. 2007..New evidence suggests that early tracheostomy placement may facilitate the ventilator withdrawal process in those patients requiring prolonged ventilatory support... - Respiratory mechanics in the patient who is weaning from the ventilatorNeil R MacIntyre
Respiratory Care Services, PO Box 3911, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 50:275-86; discussion 284-6. 2005..Fifth, many of these management objectives can be effectively carried out with protocols executed by nonphysicians... - Ventilator-associated pneumonia: the role of ventilator management strategiesNeil R MacIntyre
Respiratory Care Services, PO Box 3911, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 50:766-72; discussion 772-3. 2005..Finally, properly performed weaning protocols based on clinical evidence should reduce any iatrogenic delays in ventilator weaning and thereby minimize prolongation of unneeded mechanical ventilatory support... - Respiratory therapies in the critical care setting. Should aerosolized antibiotics be administered to prevent or treat ventilator-associated pneumonia in patients who do not have cystic fibrosis?Neil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 52:416-21; discussion 421-2. 2007..Importantly, the clinical evidence that aerosolized antibiotics can treat established VAP is negative, and multiple consensus groups recommend against treating established VAP with aerosolized antibiotics... - Ventilatory Management of ALI/ARDSNeil MacIntyre
Division of Pulmonary, Allergy, and Critical Care, Duke University Medical Center, DUMC 3911, Durham, NC 27710, USA
Semin Respir Crit Care Med 27:396-403. 2006..This has resulted in significant improvements in outcomes. Future developments will need to further refine this lung protective concept... - Management of patients requiring prolonged mechanical ventilation: report of a NAMDRC consensus conferenceNeil R MacIntyre
Duke University Medical Center, Durham, NC 27710, USA
Chest 128:3937-54. 2005..The document was reworked with input from all concerned until a final product with consensus recommendations on 12 specific issues was achieved... - Corticosteroid therapy and chronic obstructive pulmonary diseaseNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 51:289-96. 2006..Clinical evidence is particularly strong supporting the use of inhaled corticosteroids to prevent exacerbations and oral corticosteroids to reduce the duration and impact of exacerbations... - Chronic obstructive pulmonary disease: emerging medical therapiesNeil R MacIntyre
Respiratory Care Services, Department of Medicine, Duke University Medical Center, PO Box 3911, Durham NC 27710, USA
Respir Care 49:64-9; discussion 69-71. 2004..Of those tiotropium appears to be the closest to receiving clinical approval in the United States. The risk/benefit ratio and the cost-effectiveness of the other compounds are less clear and await additional study... 
Acute exacerbations and respiratory failure in chronic obstructive pulmonary diseaseNeil MacIntyre
Duke University Medical Center, Durham, NC 27710, USA
Proc Am Thorac Soc 5:530-5. 2008..quot; Although mild episodes of AECOPD are generally reversible, more severe forms of respiratory failure are associated with a substantial mortality and a prolonged period of disability in survivors...- Spirometry for the diagnosis and management of chronic obstructive pulmonary diseaseNeil R MacIntyre
Duke University Hospital, Durham, NC 27710, USA
Respir Care 54:1050-7. 2009..This can be used to guide therapies and predict outcomes. Using spirometry to screen for obstructive lung disease, however, can be problematic, and the effect of screening on outcomes has yet to be demonstrated... - Mechanisms of functional loss in patients with chronic lung diseaseNeil R MacIntyre
Respiratory Care Services, PO Box 3911, Duke University Medical Center, Durham NC 27710, USA
Respir Care 53:1177-84. 2008..Other less well understood factors include excessive dyspnea, impaired motivation, orthopedic issues, and psychiatric issues... - Muscle dysfunction associated with chronic obstructive pulmonary diseaseNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 51:840-7; discussion 848-52. 2006..Resistive breathing training is more controversial. Lung-volume-reduction surgery may help with the hyperinflation effects and improve gas exchange and respiratory-muscle function in selected patients... - Setting the frequency-tidal volume patternNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 47:266-74; discussion 274-8. 2002..Whether HFV will prove valuable in well-designed open lung strategies in the adult population still has to be determined... - Patient-ventilator interactions: optimizing conventional ventilation modesNeil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 56:73-84. 2011..Clinicians need to know how to use these ventilation mode and monitor them properly, especially understanding the airway pressure and flow graphics. The clinical challenge is synchronizing ventilator gas delivery with patient effort... - Invasive mechanical ventilation in adults: conference summaryNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 47:508-18. 2002 - Are there benefits or harm from pressure targeting during lung-protective ventilation?Neil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Hospital, Box 3911, Durham NC 27710, USA
Respir Care 55:175-80; discussion 180-3. 2010..Indeed, as is often the case in managing complex life-support devices, it is operator expertise rather than the device design features that most impacts patient outcomes... - Aerosol delivery through an artificial airwayNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 47:1279-88; discussion 1285-9. 2002..Novel approaches, such as generating the aerosol within the airway, offer the opportunity to greatly increase deposition efficiency and focal drug targeting in intubated patients... - Is there a role for screening spirometry?Neil R MacIntyre
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, USA
Respir Care 55:35-42. 2010..The value of spirometry is increased when it is of good quality, is interpreted properly, and is used in high-risk populations as a case-finding rather than a screening tool... - Intratracheal catheters as drug delivery systemsN R MacIntyre
Respiratory Care Services, Duke University Medical Center, PO Box 3911, Durham NC 27710
Respir Care 46:193-7. 2001..These catheters could be coupled with tracheal gas insufflation systems, not only to deliver therapeutic aerosols but also to create water aerosols to supply necessary humidification during tracheal gas insufflation... - Respiratory controversies in the critical care setting. Conference summaryIra M Cheifetz
Division of Pediatric Critical Care Medicine, Duke Children s Hospital, Box 3046, Durham, NC 27710, USA
Respir Care 52:636-44. 2007..This Journal Conference queried the status quo to better enable clinicians to make informed decisions in the care of their critically ill patients... - Patient-ventilator synchrony during pressure-targeted versus flow-targeted small tidal volume assisted ventilationLi Yu Yang
Department of Medicine, Duke University Medical Center, PO Box 3911, Durham, NC 27710, USA
J Crit Care 22:252-7. 2007..We hypothesized that a variable-flow, pressure-targeted breath would improve breathing effort versus a fixed flow-targeted breath... - Respiratory system simulations and modelingNeil R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, North Carolina, USA
Respir Care 49:401-8; discussion 408-9. 2004.... - Setting the positive expiratory-end pressure-FIO2 in acute lung injury/acute respiratory distress syndromeNeil R MacIntyre
Department of Pulmonary and Critical Care, Duke University Medical Center, Box 3911, Erwin Road, Durham, NC 27710, USA
Respir Care Clin N Am 10:301-8, v. 2004..Mechanical approaches to achieve this balance are clinically difficult to do. Thus gas exchange algorithms with modest PaO2 goals are commonly used today. Recruitment maneuvers and long inspiratory time strategies may be useful adjuncts... - The "best" tidal volume for managing acute lung injury/acute respiratory distress syndromeNeil R MacIntyre
Department of Pulmonary and Critical Care, Duke University Medical Center, Box 3911, Erwin Road, Durham, NC 27710, USA
Respir Care Clin N Am 10:309-15, v. 2004..Clinical trials have shown that limiting maximal and tidal stretch improves outcomes, even if gas exchange is partially compromised. Current strategies should focus on limiting tidal and maximal stretch as much as possible... - Intrabreath diffusing capacity of the lung in healthy individuals at rest and during exerciseYuh Chin T Huang
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
Chest 122:177-85. 2002..Because DL distribution in the lung is inhomogeneous, and changes in the DL in diseased lungs may be regional, measuring regional DL, especially during exercise, may be more sensitive in detecting pulmonary vascular diseases... - Aerosolized medications for altering lung surface active propertiesN R MacIntyre
Respiratory Care Services, Duke University Medical Center, Durham, North Carolina 27710, USA
Respir Care 45:676-83. 2000..Other surface active materials exist and there are small studies showing benefit when large instilled doses of these materials are given. These materials, however, have never been studied as aerosols... - Exercise outcomes after pulmonary rehabilitation depend on the initial mechanism of exercise limitation among non-oxygen-dependent COPD patientsJohn F Plankeel
Department of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC, USA
Chest 127:110-6. 2005..CONCLUSIONS: Patients with nonventilatory exercise limitations experience the greatest increase in VO2max after PR. However, even patients with severe ventilatory limitation can improve exercise tolerance with PR... - Inhaled corticosteroids in obstructive airway diseaseGhee Chee Phua
Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke University Medical Center, Durham NC 27710, USA
Respir Care 52:852-8. 2007..Newer inhaled corticosteroids with better pharmacologic properties are being developed and will probably be available in the near future... - Analysis of an endotracheal intubation service provided by respiratory care practitionersJ J Thalman
Duke Medical Center, Durham, NC 27710
Respir Care 38:469-73. 1993..CONCLUSION: Respiratory Care Services can provide an effective intubation service. Cost savings were realized by centralizing equipment... - A descriptive evaluation of transfusion practices in patients receiving mechanical ventilationMitchell M Levy
Brown University School of Medicine, Division of Pulmonary and Critical Care Medicine, Rhode Island Hospital, 593 Eddy St, Main 7, Providence, RI, 02903, USA
Chest 127:928-35. 2005..To characterize and compare transfusion practices in a broad sample of patients receiving mechanical ventilation (MV) and not receiving MV in the ICU... - Respiratory controversies in the critical care setting. Part IIra M Cheifetz
Division of Pediatric Critical Care Medicine, Duke Childrens Hospital, Durham, North Carolina
Respir Care 52:406-7. 2007 - Intersession variability in single-breath diffusing capacity in diabetics without overt lung diseaseMichael B Drummond
Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA
Am J Respir Crit Care Med 178:225-32. 2008..However, little is known about the short-term intersession variability in DL(CO) in untrained subjects or how variability is affected by rigorous external quality control... - Life-threatening asthma: pathophysiology and managementNjira L Lugogo
Respiratory Care Services, Duke University Medical Center, Durham, NC 27710, USA
Respir Care 53:726-35; discussion 735-9. 2008..The early identification and appropriate management of acute asthma is critical in decreasing asthma morbidity and mortality. This paper reviews current pharmacologic and nonpharmacologic management of severe acute asthma... - Cognitive and psychological outcomes of exercise in a 1-year follow-up study of patients with chronic obstructive pulmonary diseaseCharles F Emery
Department of Psychology, Ohio State University, Columbus, OH 43210, USA
Health Psychol 22:598-604. 2003..Continued exercise among patients with COPD is associated with maintenance of physical, cognitive, and psychological functioning... - The CRIT Study: Anemia and blood transfusion in the critically ill--current clinical practice in the United StatesHoward L Corwin
Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA
Crit Care Med 32:39-52. 2004..To quantify the incidence of anemia and red blood cell (RBC) transfusion practice in critically ill patients and to examine the relationship of anemia and RBC transfusion to clinical outcomes... - Ventilator advisory system employing load and tolerance strategy recommends appropriate pressure support ventilation settings: multisite validation studyMichael J Banner
Department of Anesthesiology, University of Florida, College of Medicine, Gainesville, FL 32610, USA
Chest 133:697-703. 2008..To validate these recommendations, we performed a multisite study comparing the advisory system recommendations to experienced physician decisions... - Marital adjustment among patients with chronic obstructive pulmonary disease who are participating in pulmonary rehabilitationJamile A Ashmore
Departments of Psychology and Internal Medicine, Ohio State University, 1885 Neil Avenue, Columbus, OH 43210, USA
Heart Lung 34:270-8. 2005.... - Respiratory controversies in the critical care setting. Does airway pressure release ventilation offer important new advantages in mechanical ventilator support?Timothy R Myers
Asthma Center, Division of Pediatric Pulmonology, Rainbow Babies and Children s Hospital, Case Western Reserve University, Cleveland, OH 44106, USA
Respir Care 52:452-8; discussion 458-60. 2007..The few clinical trials to date indicate that APRV provides adequate gas exchange, but none of the data indicate that APRV confers better clinical outcomes than other ventilation strategies... - The American Association for Respiratory Care and the National Lung Health Education Program: assuring quality in spirometryNeil R MacIntyre
Respir Care 49:587-8. 2004 - Bringing scientific evidence to the ventilator weaning and discontinuation process: evidence-based practice guidelinesNeil R MacIntyre
Respir Care 47:29-30. 2002 - Standardization of the single-breath diffusing capacity in a multicenter clinical trialRobert A Wise
Johns Hopkins University School of Medicine, Baltimore, MD, USA
Chest 132:1191-7. 2007..The safety assessment of inhalable insulin required the standardization of measurement of single-breath DLCO in multicenter clinical trials to optimize test precision... - Intrabreath analysis of carbon monoxide uptake during exercise in patients at risk for lung injuryYuh Chin T Huang
Human Studies Division, National Health and Environmental Effects Research Laboratory, Environmental Protection Agency, Research Triangle Park, NC 27711, USA
Respir Med 100:1226-33. 2006..We conclude that exercise assessments of DL at low lung volumes and gas mixing properties may be sensitive indicators of lung injury...