Mortality remains high in ventilator-dependent patients with spinal cord injuries. Evidence guiding optimal ventilator management and weaning is limited, necessitating individualized care based on injury level and severity. Understanding injury-specific respiratory physiology, current evidence, and tailored liberation strategies is critical to improving outcomes after critical illness.

Effective management of acute severe asthma requires rapid assessment, coordinated medical therapy, and thoughtful respiratory support to prevent deterioration and respiratory failure. This session provides a concise, physiology-based overview of managing acute severe asthma in adults across the critical care continuum. Emphasis is placed on the respiratory therapist’s role in optimizing bronchodilator and adjunct therapies, assessing expiratory physiology, and supporting ventilation when escalation is required. Key decision points and ventilatory considerations are highlighted to promote consistent, evidence-informed care from initial presentation through inpatient management.

The transition from controlled to spontaneous breathing is a critical and physiologically vulnerable phase of mechanical ventilation, during which conventional global respiratory metrics often fail to reflect the underlying regional and dynamic processes that drive patient–ventilator interaction. Excessive effort can amplify lung stress through patient self-inflicted lung injury and pendelluft, while suppressed effort promotes diaphragm atrophy and prolongs ventilator dependence. This session explores the pathophysiological mechanisms linking effort to these outcomes and discusses the concept of a “safe zone.” Participants will gain a framework for recognizing when patients have drifted outside this range.

This presentation outlines the systematic physiological and clinical assessments required to transition patients from VV ECMO to assisted ventilation or independent pulmonary function. We will explore key aspects of weaning designed to evaluate the lungs' ability to maintain safe and adequate gas exchange without mechanical support. Attendees will gain a comprehensive understanding of the safety criteria and hemodynamic monitoring, which is essential for identifying the optimal window for decannulation. Finally, we will address the multidisciplinary coordination and post-procedure care necessary to ensure a successful recovery and minimize complications after support is withdrawn.

An understanding of physiology is fundamental to respiratory care practice. Physiologic principles, after memorization in school, are often forgotten once entering practice. This lecture covers physiologic principles related to respiratory mechanics, linking physiology to practice, particularly during mechanical ventilation.

This talk explores the role of humidification during mechanical ventilation and its impact on patient safety, comfort, and clinical outcomes. Participants will review the physiological importance of airway humidification, the consequences of inadequate or excessive humidification, and the principles behind commonly used humidification devices, including heated humidifiers and heat-and-moisture exchangers. Practical considerations for device selection, troubleshooting, and integration into different ventilation strategies will be discussed, with an emphasis on evidence-based practice in the ICU and operating room settings.

This talk examines the growing role of automation in mechanical ventilation and how closed-loop and decision-support systems are reshaping respiratory care. Participants will be introduced to the principles behind automated ventilation modes, including how patient data such as respiratory mechanics, gas exchange, and patient effort are used to adjust ventilator settings in real time. The session will highlight potential benefits — such as reduced clinician workload, improved consistency of care, and enhanced patient–ventilator interaction — as well as limitations, safety considerations, and current evidence supporting automated approaches in different clinical settings.

This talk highlights how inhaler selection, technique, and patient engagement influence real-world outcomes in obstructive lung disease. Participants will review the role of inhaled therapies across the spectrum of asthma and COPD, including bronchodilators and inhaled corticosteroids, and how device choice can affect drug delivery, adherence, and symptom control. The session will emphasize practical, bedside, and clinic-based considerations such as matching inhaler devices to patient-specific factors (inspiratory flow, coordination, cognition, and comorbidities), recognizing common inhaler errors, and reinforcing effective patient education strategies. Differences between metered-dose inhalers, dry powder inhalers, and soft mist inhalers will be discussed, along with the impact of spacers, technique reassessment, and follow-up.

Unplanned extubations, often called accidental extubations, are more common in pediatric and neonatal ICUs than in adult care areas. Unplanned extubations can result in successful extubations or have dire consequences (cardiac arrest, hypoxemia, required reintubation). As a result, hospitals spend significant time and effort to develop protocols to prevent unplanned extubations. This talk will discuss the results of important research on unplanned extubations and the effectiveness of preventive programs.

Point-of-care ultrasound (POCUS) has become an essential bedside tool in modern critical care, allowing clinicians to rapidly assess physiology, refine differential diagnoses, and guide real-time management decisions without transporting unstable patients. This lecture will describe the research on ultrasound in the critical care setting over the past year.

This session will examine how ventilator settings, particularly PEEP, inspiratory time, and mean airway pressure, directly alter right ventricular afterload and pulmonary vascular resistance, often before hypoxemia or hypotension is clinically apparent. Rather than discussing global hemodynamics, the discussion centers on why the RV fails silently during otherwise ‘acceptable’ ventilation, and how routine ventilator adjustments may unintentionally worsen RV strain.

Over-assistance is a common but often underrecognized cause of patient–ventilator asynchrony. This session will provide a practical approach to identifying discordance at the bedside using ventilator waveforms and clinical assessment. Attendees will learn how excess support affects respiratory drive, recognize hallmark patterns, and implement targeted ventilator adjustments to improve synchrony and patient outcomes.

This presentation focuses on the recognition and management of patient–ventilator discordance caused by under-assistance. Participants will review the physiologic mechanisms by which insufficient ventilatory support leads to increased work of breathing, respiratory distress, and asynchrony. Emphasis will be placed on ventilator waveform interpretation, key clinical indicators, and common patterns of discordance. Case-based examples will highlight practical strategies to optimize ventilator settings, reduce patient effort, and restore synchrony.

Types of patient-ventilator discordance are well described in the literature, but the clinical implications and outcomes are less well understood. Early work observed finite timeframes during a mechanical ventilation course and characterized the incidence and outcomes accordingly. However, larger datasets recording entire courses of mechanical ventilation have not only enabled reinterpretation of the incidence but also of the heterogeneous evolution and associated outcomes with patient-ventilator discordance. Recent literature suggests that not all discordance is associated with poor outcomes, and that the potential risks of correcting the discordance may outweigh those of the discordance itself.