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19th Annual New Horizons Symposium
Integrating Evidence-Based Respiratory Care into Clinical Practice
1:00 pm - 5:00 pm
Dean R Hess PhD RRT FAARC, Boston MA/Chairing
Evidence-based medicine entered into the lexicon of healthcare delivery
late in the 20th century. As we enter the 21st century, evidence-based
medicine has become a major principle directing clinical decision-making
in medicine and is, increasingly, affecting respiratory care practice.
This symposium will highlight respiratory care applications of evidence-based
medicine and challenge the clinician to incorporate that into practice.
Presentations will address applications of evidence-based medicine in
technical and clinical aspects of respiratory care practice.
Tracks:
Management, Education, Acute Care
1:00 pm – 1:25 pm
What is Evidence-Based Medicine and Why Should I Care?
Dean R Hess PhD RRT FAARC, Massachusetts General Hospital, Boston MA
Reviews evidence-based medicine, with examples specific to respiratory
care practice and suggestions for appropriate use of evidence-based medicine.
1:30 pm – 1:55 pm
What is the Evidence for New Ventilator Modes?
Richard D Branson RRT FAARC, Cincinnati University Medical Center, Cincinnati
OH
Addresses the current evidence to support the use of new ventilator modes.
Includes such modes as dual-control, tube compensation, airway pressure-release
ventilation, and proportional assist ventilation (and others as appropriate).
Includes other features such as rise time adjustments and variable flow
termination during pressure support. Which modes should we use? Do they
make any difference? Are they cost effective?
2:00 pm – 2:25 pm
What is the Evidence That Respiratory Care Protocols Work?
James K Stoller MD MS FAARC, The Cleveland Clinic, Cleveland OH
Discusses the motivations for the use of protocols. Covers the evidence
that respiratory care protocols work, including quality of care outcomes
and fiscal outcomes.
2:30 pm – 2:55 pm
Evidence-Based Asthma Management
Thomas J Kallstrom RRT AE-C FAARC, Fairview Hospital, Cleveland OH
Discusses the current evidence for management of the patient with asthma,
with specific emphasis on the role of the respira- tory therapist.Included
are the role of inhaled medications (bronchodilators, steroids, and others),
selection of aerosol delivery device (nebulizer, pressurized metered-dose
inhaler, dry powder inhaler), gas therapy (heliox, anesthetics), patient
education, and mechanical ventilation (invasive and noninvasive). Reviews
the role of guidelines (NAEPP) in the management of asthma.
2:55 pm – 3:05 pm
Break
3:05 pm – 3:30 pm
Evidence-Based Inpatient Management of COPD
Scott Epstein MD, Tufts University Medical School, Boston MA
Care of patients with COPD remains a major focus of the practice of respiratory
therapists. Presents the role of inhaled medications (bronchodilators,
steroids), selection of aerosol delivery device (nebulizer, pressurized
metered-dose inhaler, dry powder inhaler), gas therapy (oxygen, heliox),
secretion clearance techniques (chest physiotherapy, mucolytics), surgical
therapies and mechanical ventilation (invasive and noninvasive). Provides
evidence to support these interventions will be provided. Discusses the
role of guidelines (GOLD) in the management of COPD.
3:35 pm – 4:00 pm
Evidence-Based ARDS Management
Richard Kallet MS RRT FAARC, University of California at San Francisco
General Hospital, San Francisco CA
Focuses on the mechanical ventilation of ARDS patients including selection
of tidal volume, PEEP, mode (volume control, pressure control, new modes
like APRV and HFO), and the role of recruitment maneuvers. Describes
the role of prone positioning and pharmacological therapy (steroids,
nitric oxide, and others).
4:05 pm – 4:30 pm
Evidence for Use of NPPV in Patients with Acute Respiratory Failure
Dean R Hess PhD RRT FAARC
Over the past 10 years, considerable evidence has evolved to support
the use of noninvasive ventilation in appropriately selected patients.
This presentation will include a discussion of patient selection for
NPPV, equipment selection for NPPV, and monitoring the patient receiving
NPPV. Also included will be issues such as aerosol delivery during NPPV
and heliox therapy with NPPV.
4:35 pm – 5:00 pm
Evidence-Based Weaning from Mechanical Ventilation
Neil R MacIntyre MD FAARC, Duke University Medical Center, Durham NC
One of the most controversial aspects of mechanical ventilation relates
to the liberation of patients from the ventilation. Discusses the issues
related to identification of weaning readiness, the role of weaning parameters,
the importance of a spontaneous breathing trial, the role of ventilator
modes, causes of prolonged ventilator dependence, timing of tracheos-tomy,
and the role of weaning protocols. Includes recently published guidelines
for weaning from mechanical ventilation.