1 Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, NC. 2 Department of Respiratory Therapy, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY. Dr. MacIntyre received funding from Hillrom, Ventec, and Vyaire, and he received support for article research from the National Institutes of Health. The remaining authors have disclosed that they do not have any potential conflicts of interest.