Physicians

Chief, Clinical Services

Department / Division
Medicine / Medicine-Pulmonary

Address
DUMC 3911
Durham, NC 27710

Office Telephone
919-681-2720

Fax Telephone
919-681-2892

Training

• MD, Weill Cornell Medical College (New York), 1972

Residency

• Internal Medicine, Cornell-New York Hospital, 1973-1975

Fellowship

• Pulmonary, UCSF Medical Center (California), 1978-1981

Clinical Interests
Pulmonary-function testing, pulmonary rehabilitation, mechanical ventilation

Research Interests
1)  Mechanical Ventilation and respiratory failure.  Current projects involve studying patient-ventilator interactions during modes of support that require patient activity.  The focus is on ventilatory muscle function during these assisted modes.   Other projects include evaluating respiratory system mechanics in acute respiratory failure and the role of ECMO in the adult. Duke is also one of several institutions in the NIH ARDS Network, a consortium designed to perform multi-center trials.

2)  Diffusing capacity of the lung for carbon monoxide.  Current projects involve using a rapidly responding gas analyzer to measure lung diffusing capacity in discrete regions of the lung. These analyses are being extended into mechanically ventilated patients.

3)  COPD.  Current projects involve studying the physiology of cardio-respiratory conditioning in patients with obstructive lung disease and the role of pulmonary rehabilitation in improving COPD outcomes. Duke is also a member of two NIH sponsored multicenter programs: the COPDgene project correlating genetic profiles with physiologic/clinical phenotypes; and the NIH LOTT project evaluating the role of oxygen therapy in exercise and sleep hypoxemia.

4)  Aerosol delivery systems.  The current project is the development of a prototype aerosol generating catheter that can be directly inserted into the airways. Studies are being conducted in both ex vivo animal lungs and in mechanically ventilated patients.

Industry Relationships and Collaborations (What's this?)

This physician (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.

• Breathe Technology
• Carefusion
• Trudell Medical

Representative Publications
Yang LY, Huang YC, Macintyre NR. Patient-ventilator synchrony during pressure-targeted versus flow-targeted small tidal volume assisted ventilation. J Crit Care. 2007 Sep;22(3):252-7. (2007) Abstract

Macintyre N, Crapo RO, Viegi G, Johnson DC, van der Grinten CP, Brusasco V, Burgos F, Casaburi R, Coates A, Enright P, Gustafsson P, Hankinson J, Jensen R, McKay R, Miller MR, Navajas D, Pedersen OF, Pellegrino R, Wanger J. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J. 2005 Oct;26(4):720-35. (2005) Abstract

Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A, Ancukiewicz M, Schoenfeld D, Thompson BT, . Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med. 2004 Jul 22;351(4):327-36. (2004) Abstract

Huang YC, O'Brien SR, MacIntyre NR. Intrabreath diffusing capacity of the lung in healthy individuals at rest and during exercise. Chest. 2002 Jul;122(1):177-85. (2002) Abstract

MacIntyre NR, Cook DJ, Ely EW Jr, Epstein SK, Fink JB, Heffner JE, Hess D, Hubmayer RD, Scheinhorn DJ, , , . Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001 Dec;120(6 Suppl):375S-95S. (2001) Abstract

6) MacIntyre NR, McConnell R, Cheng KC. Applied PEEP reduces the inspiratory load of intrinsic PEEP during pressure support. Chest 1997; 111:188-193. (1997)

MacIntyre NR, Leatherman NE. Ventilatory muscle loads and the frequency-tidal volume pattern during inspiratory pressure-assisted (pressure-supported) ventilation. Am Rev Respir Dis. 1990 Feb;141(2):327-31. (1990) Abstract

MacIntyre NR, Leatherman NE. Mechanical loads on the ventilatory muscles. A theoretical analysis. Am Rev Respir Dis. 1989 Apr;139(4):968-73. (1989) Abstract

MacIntyre NR, Leatherman N, Deitz JL, Wagoner R, Friedman M. Distribution and uptake of helium, carbon monoxide, and acetylene in the lungs during high frequency oscillatory ventilation. Respir Physiol. 1986 Feb;63(2):201-12. (1986) Abstract

MacIntyre NR. Respiratory function during pressure support ventilation. Chest. 1986 May;89(5):677-83. (1986) Abstract