AARC Congress 2016

8:40 am–9:30 am | Room TBA | Clinical Practice

Pulmonary Rehabilitation: Where We’ve Succeeded and Where We’ve Failed

Richard Casaburi MD MEngr PhD, Ranch Palos Verdes CA

Pulmonary rehabilitation is of unquestioned benefit to COPD patients. The scientific basis of this therapy is firmly established. Yet it is available to a very small fraction of those who would benefit from it. In the cases of smoking cessation and inhaled bronchodilators, forces have been brought to bear to impact the vast majority of COPD patients. This lecture will examine the reasons for this discrepancy and suggest a way forward.

10:30 am–11:05 am | Room TBA | Neonatal/Pediatric

The Phenotypes of BPD

Huyan Zhang MD, Philadelphia PA

Although generally viewed as a single clinical entity, bronchopulmonary dysplasia is a compilation of several clinical entities. This presentation will discuss the various presentations for BPD as well as its implications for clinical management.

11:10 am–11:45 am | Room TBA | Neonatal/Pediatric

Challenges in Mechanical Ventilation for Severe BPD

Cheryl Lew MD, Topanga CA

Mechanical ventilation of infants with severe BPD can be challenging. Strategies to assist with stabilization of the ventilation status of these vulnerable infants, while treating the overall syndrome, will be discussed.

11:50 am–12:25 pm | Room TBA | Neonatal/Pediatric

BPD Outcomes in 2016: What To Expect

Huyan Zhang MD, Philadelphia PA

Outcomes for infants with chronic lung disease are gradually improving. This presentation will review the available outcome data for these vulnerable infants. Speculations for the future will be discussed.

10:30 am–11:05 am | Room TBA | Adult Critical Care

Alleviating Asynchrony in Pressure Ventilation

John Davies MA RRT FAARC, Durham NC

Pressure control ventilation is often touted as a method to improve synchrony compared to volume control. However, loss of control of tidal volume is an area of concern. When limiting VT during pressure control, what are the methods for improving synchrony in the patient with air hunger?

11:10 am–11:45 am | Room TBA | Adult Critical Care

Can Specialized Modes Reduce Asynchrony?

Robert L Chatburn MHHS RRT-NPS FAARC, Cleveland OH

A number of new modes have been introduced over the years to improve patient ventilator synchrony. Prominently, these include PAV and NAVA. How do these techniques improve synchrony and does improving synchrony result in an improved outcome?

11:50 am–12:25 pm | Room TBA | Adult Critical Care

Alleviating Asynchrony in Volume Ventilation

Eduardo Mireles-Cabodevila MD, Cleveland OH

Volume control ventilation remains the standard of care for ARDS. However, volume control ventilation at fixed flows and flow pattern can adversely impact the work of breathing. Tricks of the trade for maximizing synchrony during volume control will be reviewed.

1:45 pm–2:20 pm | Room TBA | Clinical Practice

Evaluation of the SIMEX Intermittent Subglottic Aspiration System in Patients Requiring Chronic Mechanical Ventilation

Jerry Gentile BSRT BSHA MBA EdD(c) RRT, Long Island NY

Tracheostomized patients receiving chronic mechanical ventilation are at risk for ventilator associated events, including pneumonia. Experience with the SIMEX Intermittent Subglottic Aspiration System in this population will be presented.

2:25 pm–3:00 pm | Room TBA | Clinical Practice

uProtecting the Airway, Facilitating Speech and Decannulation: The Role of the Speech Pathologist

Terry Eberly MA CCC-SLP, Denver CO

The physician, respiratory therapist, and speech and language pathologist are important team members in managing patients requiring long term ventilation, particularly when goals are set to minimize risk of aspiration, restore speech, introduce oral feeding with intact swallow, and achieve successful tracheostomy tube decannulation.

3:05 pm–3:40 pm | Room TBA | Clinical Practice

Tracheostomies for Respiratory Therapists: "The Hole Story"

Eric S Yaeger MD, Denver CO
Dorene Siegwarth RRT-ACCS Denver CO

There are many different brands and types of tracheostomy tubes. Most practitioners are only exposed to a few, usually those used in their facilities. This presentation will provide a detailed overview of the different ways tracheostomies are performed and the advantages and disadvantages for using different types of tracheostomy tubes to promote weaning, cuff deflation trials, capping, and decannulation. The presentation will conclude with the options for long-term use in tracheostomy-dependent patients, and the options that can be used in difficult airways such as patients with tracheal prolapse, malacia, stenosis, trauma, and obesity.

1:45 pm–2:20 pm | Room TBA | Pulmonary Function

Indications for Cardiopulmonary Exercise Testing (CPET)

Katrina Hynes MHA RRT RPFT, Rochester MN

Review the clinical indications for exercise testing in patients that have specific signs or symptoms associated with exercise.

2:25 pm–3:00 pm | Room TBA | Pulmonary Function

CPET: Quality Assurance

Susan Blonshine RRT RPFT AE-C FAARC, Manson MI

Accurate exercise VO2 results are dependent on multiple components aligning correctly in an exercise system. The presentation will review the components and quality control methods to ensure accuracy. Recent multi-center studies are defining methods to incorporate biologic control data to predict equipment function within and between PF laboratories to decrease the variability of the measurements. The presenter will review the literature in regards to acceptable biologic quality control and expected ranges.

3:05 pm–3:40 pm | Room TBA | Pulmonary Function

CPET: Test Performance

Katrina Hynes MHA RRT RPFT, Rochester MN

A sophisticated review will be provided describing the selection of appropriate equipment and testing protocols to elicit a maximal exercise performance.

3:45 pm–4:20 pm | Room TBA | Pulmonary Function

CPET: Cardiac and Ventilatory Response

Carl Mottram RRT RPFT FAARC, Rochester MN

The cardiac and ventilatory response during exercise are key elements of a cardiopulmonary exercise test. These responses will be reviewed as a component of a comprehensive exercise test assessment. This includes a review of the normal and abnormal breathing strategies used to recruit the required minute ventilation to meet the subject's metabolic needs.

1:45 pm–2:20 pm | Room TBA | Adult Critical Care

Automated Control of FIO2

Richard Branson MSc RRT FAARC, Cincinnati OH

Systems are under development to allow automated control of FIO2 during mechanical ventilation. This presentation will cover potential benefits for this approach.

2:25 pm–3:00 pm | Room TBA | Clinical Practice

How Should Aerosols be Delivered During Mechanical Ventilation?

Rajiv Dhand MD FCCP FACP FAARC, Knoxville TN

What drugs should be delivered by aerosol to mechanically ventilated patients? What is the optimal delivery system?

3:05 pm–3:40 pm | Room TBA | Clinical Practice

Inhaled Carbon Monoxide: From Toxin To Therapy

Dean R Hess PhD RRT FAARC, Boston MA

Carbon monoxide is commonly recognized as a toxic gas. In recent years experimental evidence supports that low dose inhaled carbon monoxide might have therapeutic benefit.

3:45 pm–4:20 pm | Room TBA | Clinical Practice

What Is the Current Role for Heliox?

Ira M Cheifetz MD FAARC FCCM, Durham NC

Heliox has been available for many years. What is the current evidence supporting its use?

4:25 pm–5:00 pm | Room TBA | Clinical Practice

After 25 Years, What Do We Know About Inhaled Nitric Oxide?

Robert M Kacmarek PhD RRT, Littleton MA

Inhaled nitric oxide has become entrenched in respiratory care practice. But where is the evidence? What is the future?

1:45 pm–3:00 pm | Room TBA | Management

Opening the Door - Expanding RTs’ Roles in the Delivery of Health Care

Cheryl West MHA, Irving TX
Anne Marie Hummel Woodbridge VA

The AARC Respiratory Therapist Human Resources Study 2014 found that only 2.1% of RTs - or over 3,500 RTs if extrapolated to the general RT working population - work in physician's offices. Since the delivery of health care has changed dramatically, especially with the passage of the Affordable Care Act, you might be missing out on new opportunities. This seminar will bring you up-to-date on important new Federal initiatives that can enhance your role as disease managers in physicians? practices and provide you with tools to market your expertise in this setting. In light of the spotlight on COPD readmissions penalties and improving care coordination among providers, gaining knowledge of how physicians can utilize your skills in their practices becomes all the more important.

1:45 pm–3:00 pm | Room TBA | Neonatal/Pediatric

PRO/CON: Should HFOV Be Abandoned for Pediatric ARDS?

Ira M Cheifetz MD FAARC FCCM, Durham NC
Alexandre T Rotta MD Cleveland OH

Despite the growing evidence against the use of HFOV for adults with ARDS, the situation for the pediatric patient remains uncertain. Data in pediatrics remain non-definitive. This debate between two experts in the field will review both the rationale for the use of high-frequency ventilation as well as the available data. To show their equipoise, the speakers will flip a coin at the start of the presentation to determine who will argue which side of this ongoing debate.

3:05 pm–4:20 pm | Room TBA | Neonatal/Pediatric

PRO/CON: Should HFNC Be Used as the First Line of Support for all Infants with Respiratory Distress?

PRO: Rob DiBlasi BSRT RRT-NPS FAARC, Seattle WA
CON: Keith Hirst MS RRT-NPS Boston MA

The use of high flow nasal cannula to support neonates with respiratory distress is increasing at a rapid rate. Is the use of this technology appropriate in these situations or is it being inappropriately applied? The PRO side of this debate will support the use of HFNC for all forms of neonatal respiratory distress prior to consideration of other modes of respiratory support.

1:45 pm–2:20 pm | Room TBA | Adult Critical Care

Ventilator-Associated Events: Background and Definitions

Lorenzo Berra MD, Boston MA

The new CDC definitions for VAE and VAI replacing the traditional VAP have resulted in a significant challenge for hospitals and RT departments. This study will provide the rationale for the development of this scheme and how to apply it to ICU metrics.

2:25 pm–3:00 pm | Room TBA | Adult Critical Care

Tracking VAE’s Difficulties and Conflicting Issues for the RT

Kathleen Deakins MSHA RRT-NPS FAARC , Cleveland OH

Respiratory therapists are often tasked with tracking VAE and IVAC in critically ill patients. What are the clinical events associated with VAEs which complicate the CDC definition. When do VAE events occur and what is their temporal association to procedures and therapy?

3:05 pm–3:40 pm | Room TBA | Adult Critical Care

A New Paradigm for Secretion Clearance: Insufflation/Exsufflation and Cleaning the Tube

Lorenzo Berra MD, Boston MA

The standard of care for airway clearance of the ventilated patient is closed circuit suctioning. New devices for cleaning the tube to remove secretions and biofilm may be improvements to and avoid the complications of negative pressure from traditional airway suctioning. The role of insufflation/exsufflation in ventilated patients will also be explored.

3:45 pm–4:20 pm | Room TBA | Adult Critical Care

A Hypothesis for the Impact of Subglottic Secretion Tubes

Thomas Piraino RRT FCSRT, Beamsville Ontario

Subglottic suctioning tubes are uniformly recommended by practice guidelines for the prevention of early pneumonia in the ventilated patient. The practical implementation however, has been problematic. This talk will evaluate the literature on this topic and propose a new interpretation of the literature.

1:45 pm–2:20 pm | Room TBA | Clinical Practice

Odds Are You Can Do This! Understanding the Results of Medical Studies

Jody Lester MA RRT, Boise ID

The statistical data reported in medical studies can be complicated and intimidating. This presentation will use statistics from recently published medical studies to practice the interpretation of odds ratios, risk ratios, absolute risk reduction, number needed to treat, survival data, and forest plots.

2:25 pm–3:00 pm | Room TBA | Clinical Practice

Research Soup To Nuts

Jeffrey M Haynes RRT RPFT FAARC, Nashua NH

This presentation will describe how a simple research project can be done in a small hospital using a real-life example. All of the steps in completing the study up to and including publication will be described? from "soup to nuts!"

3:05 pm–3:40 pm | Room TBA | Clinical Practice

Studying a Study • Using a Systematic Approach to Evaluate Medical Research

Jody Lester MA RRT, Boise ID

In today's rapidly changing world of clinical practice, old assumptions quickly fall under the weight of new evidence. Clinicians must be able to select and appraise medical studies. Participants in this session will be introduced to, and practice using, the MAARIE framework - a step by step method for evaluating medical studies.

3:05 pm–3:40 pm | Room TBA | Clinical Practice

The Role of Patient-Centric Care in Chronic Disease Management

Patrick Dunne MEd RRT FAARC, Fullerton CA

Attendees will be able to describe the concept and attributes of true patient-centric care. The importance of patient-centric care in attaining successful chronic disease outcomes will be discussed, as will the impact of recent CMS regulations requiring discharge planning activities to be based upon patient preferences and needs.

3:45 pm–4:20 pm | Room TBA | Clinical Practice

Why I Now Care About My Self-Care: A Patient Perspective

Bob Castle , Austin TX

Attendees will hear a first-hand account of one patient's journey from being a recipient of prescribed care (with limited input) to using self-education on his medical condition and a proactive voice to become actively involved in his care. The presenter will describe how he became a successful, active participant in his collaborative self-care. Positive physician and RT influences and activities that helped facilitate this transition will be discussed.

4:25 pm–5:00 pm | Room TBA | Clinical Practice

Obstacles on the Road to Patient-Centric Care: Important Considerations

Brian Carlin MD, Sewickley PA

Attendees will be able to list common obstacles that arise when moving from the traditional model of physician-directed care to the newer concept of patient-centric care. Useful strategies to help overcome commonly encountered physician resistance to patient-centric care will be discussed, including the important role of the RT. The RT must continue to refine interpersonal skills in interviewing and engaging the patient to understand operative, medical, and personal needs.

3:45 pm–4:20 pm | Room TBA | Sleep Medicine

Latest Finds of 2015 in Sleep

Karen Schell DHSc RRT-NPS RRT-SDS RPFT RPSGT AE-C CTT, Kansas City KS

4:25 pm–5:00 pm | Room TBA | Sleep Medicine

Future Research in Sleep

Meena Khan MD, Ohio

What does the future of sleep medicine hold? Both current and future studies have a strong role in both the RT and sleep world. What has current research shown us and what are the trends? How will this impact our patient care in the future?