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Neil R. MacIntyre
Duke University
293Publications
52H-index
36.3kCitations
Publications 296
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COPD is a chronic inflammatory process in the airways (and often in the adjacent alveolar spaces) that afflicts millions of patients in the United States alone. Pathologic changes are generally irreversible, and the disease is characterized by progressive respiratory deterioration punctuated by
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#1Rachel N. Criner (UPenn: University of Pennsylvania)
#2Charles Hatt (UM: University of Michigan)H-Index: 2
Last.MeiLan K. Han (UM: University of Michigan)H-Index: 51
view all 13 authors...
Impaired single breath carbon monoxide diffusing capacity (DLCO) is associated with emphysema. Small airways disease (SAD) may be a precursor lesion to emphysema, but the relationship between SAD and DLCO is undescribed. We hypothesized that in mild COPD, functional SAD (fSAD) defined by computed tomography (CT) and Parametric Response Mapping methodology would correlate with impaired DLCO. Using data from ever-smokers in the COPDGene cohort, we established that fSAD correlated significantly wit...
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#1Victor Kim (TU: Temple University)H-Index: 23
#2H. Zhao (TU: Temple University)H-Index: 4
Last.Mario E. RuizH-Index: 5
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Background Chronic bronchitis (CB) increases risk of COPD exacerbations. We have shown that the St. George’s Respiratory Questionnaire (SGRQ) CB definition identifies patients with a similar clinical phenotype as classically defined CB. Whether the SGRQ CB definition is a predictor of future COPD exacerbations is unknown. Methods We analyzed 7,557 smokers with normal spirometry and Global Initiative for Chronic Obstructive Lung Disease stage 1-4 COPD in the Genetic Epidemiology of COPD study wit...
1 CitationsSource
#1Craig R. Rackley (Duke University)H-Index: 8
#2Neil R. MacIntyre (Duke University)H-Index: 52
Since the first description of mechanical ventilation, our understanding of the positive and negative effects of this form of life support has continued to evolve. To maintain “normal” aeration of the lungs and “normal” blood gas measurements, patients often require much higher airway pressures and tidal volumes than would be expected in a healthy, spontaneously breathing adult. In the early days of mechanical ventilation, the goal was to normalize the blood gas levels, but over the last several...
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#1Aparna Balasubramanian (Johns Hopkins University)
#2Neil R. MacIntyre (Duke University)H-Index: 52
Last.Meredith C. McCormack (Johns Hopkins University)H-Index: 25
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Background Diffusing capacity of the lung for carbon monoxide (Dlco) is inconsistently obtained in patients with COPD, and the added benefit of Dlco testing beyond that of more common tools is unknown. Objective The goal of this study was to determine whether lower Dlco is associated with increased COPD morbidity independent of emphysema assessed via spirometry and CT imaging. Methods Data for 1,806 participants with COPD from the Genetic Epidemiology of COPD (COPDGene) study 5-year visit were a...
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Noninvasive ventilation (NIV) has a number of physiologic effects similar to invasive ventilation. The major effects are to augment minute ventilation and reduce muscle loading. These effects, in turn, can have profound effects on the patient9s ventilator control system, both acutely and chronically. Because NIV can be supplied with PEEP, the maintenance of alveolar recruitment is also made possible and the triggering load imposed by auto-PEEP can be reduced. NIV (or simply mask CPAP) can mainta...
1 CitationsSource
#1F.S.S. Leitao Filho (UBC: University of British Columbia)
#2Andre Mattman (UBC: University of British Columbia)H-Index: 16
Last.Don D. Sin (UBC: University of British Columbia)H-Index: 67
view all 30 authors...
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#1Aparna Balasubramanian (Johns Hopkins University)
#2Robert J. Henderson (Johns Hopkins University)H-Index: 3
Last.Robert A. Wise (Johns Hopkins University)H-Index: 88
view all 19 authors...
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#1David A. Kaminsky (UVM: University of Vermont)H-Index: 25
#2Allan L. CoatesH-Index: 37
Last.Jack WangerH-Index: 10
view all 8 authors...
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The ventilator discontinuation process involves both disease resolution and proper support to facilitate recovery. This support includes optimizing nutrition, fluid-electrolyte balance, and infection control as well as avoiding problems such as ventilator-induced lung injury, discomfort, and
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