This presentation equips respiratory therapists with foundational skills for using lung ultrasound for bedside assessment and advanced monitoring. Key imaging patterns, scanning techniques, and clinical applications in ventilator management will be highlighted.

This session focuses on the use of esophageal manometry to assess lung mechanics and patient–ventilator interaction in mechanically ventilated patients. During passive ventilation, esophageal pressure is used to evaluate lung compliance, chest wall mechanics, and transpulmonary pressures, providing a more precise understanding of lung stress. During spontaneous breathing, esophageal manometry allows clinicians to quantify patient effort, detect asynchrony, and optimize ventilator support. Through case-based examples, participants will learn to integrate esophageal pressure data into bedside decision-making, guiding ventilator adjustments to prevent ventilator-induced lung injury, reduce the work of breathing and improve synchrony.

The panel will discuss why conventional global metrics, such as airway driving pressure, may fail to reflect regional lung behavior and dynamic changes over time. Attendees gain an understanding of how EIT provides real-time, bedside assessment of regional ventilation, revealing heterogeneity, recruitment, and overdistension that remain invisible with standard monitoring. This session will also explore the technology's utilization during spontaneous ventilation and assessment of volume distribution and respiratory effort.

Early mobility and rehabilitation of mechanically ventilated patients are increasingly recognized as critical components of care. This affects patients across acute, long-term acute care, rehabilitation, and home settings. This presentation will address patient selection, ventilator modes and settings, equipment considerations, secretion management, and oxygenation during activity, enabling respiratory therapists to actively contribute to rehabilitation goals and improve patient outcomes.

This presentation focuses on the role of respiratory therapists in implementing the A-F Bundle to enhance patient care in the ICU. Participants will explore each component of the bundle, highlighting evidence-based strategies that directly involve respiratory therapy interventions. The session will emphasize practical approaches to integrating the bundle into daily practice, improving interdisciplinary collaboration, and optimizing patient outcomes, while addressing potential challenges and barriers in real-world ICU settings.

The mortality rate associated with ARDS remains high despite guideline-driven mechanical ventilation strategies, and clinicians often have to implement strategies based on physiology, experience, and resources. This presentation explores how APRV is an option that leverages lung physiology to provide supportive mechanical ventilation and potentially mitigate known mechanisms of VILI. Alveolar behavior is unpacked as this presentation examines the physiologic foundations of APRV, focusing on time–pressure relationships, alveolar recruitment dynamics, and the impact of prolonged high-pressure phases on functional residual capacity. Key concepts such as stress and strain, recruitment–de-recruitment, and intrinsic PEEP will be discussed in the context of APRV’s unique ventilatory pattern.

This presentation provides a practical overview of initiating airway pressure release ventilation (APRV) and selecting appropriate ventilator settings to optimize oxygenation and ventilation. Participants will review key principles of APRV, including timing (Thigh/Tlow), pressure settings (Phigh/Plow), and patient interaction. The session will also address common barriers to successful initiations, such as clinician unfamiliarity, variability in protocols, and patient-ventilator asynchrony—as well as potential adverse consequences, including hemodynamic compromise, volutrauma, and challenges in CO2 clearance. Emphasis will be placed on safe implementation and patient selection.

This presentation focuses on the ongoing assessment and management of APRV following initiation. Participants will explore strategies to monitor patient response, optimize ventilator settings, and ensure effective gas exchange while minimizing risks. Key topics include evaluating oxygenation and ventilation, adjusting Thigh, Tlow, Phigh, and Plow in real time, recognizing patient-ventilator asynchrony, and identifying complications such as overdistension, hypercapnia, or hemodynamic compromise. Practical guidance will be provided for balancing lung protection with individualized patient needs, emphasizing safe, dynamic management.

The decision to perform a tracheostomy is often difficult for patients, caregivers, and healthcare professionals. The timing of a tracheostomy is often controversial. Once a tracheostomy has been performed, optimal management is often not delivered in accordance with evidence-based principles. This discussion will focus on the evidence for tracheostomy performance and on postoperative management (including decannulation). A case-based approach will serve as the basis for this discussion.