59th RESPIRATORY CARE Journal Conference

 

COPD: Current Evidence and Implications for Practice

June 2–3, 2020

Vinoy Renaissance Resort (Plaza C–D Ballroom)
St Petersburg, Florida

Neil R MacIntyre MD FAARC
MeiLan Han MD
Thomas Kallstrom MBA RRT FAARC
Conference Co-chairs

Attendance limited to faculty, representatives from supporting organizations, and staff.

Overview

COPD is a major cause of morbidity and mortality in the world. In the last decade numerous advances in our understanding of the disease and improved management strategies have emerged. The conference faculty are key thought leaders from both basic science and clinical disciplines with expertise in COPD. The conference has two overarching goals: The first is to address current thinking on the definition, pathophysiology and natural history of COPD that incorporate newer imaging techniques, metabolic processes, genetics, and epidemiology. The second is to translate these developments into practical diagnostic, prognostic, and management tools for clinicians. These proceedings will provide clinicians with a deeper understanding of COPD and its management.

Presentation Rules
  • Each presenter will have 30 minutes for a concise presentation. No additional time will be allotted. At the conclusion of each presentation, there will be a 15-minute open discussion.
  • Each presentation MUST focus on the key issues and include thoughts for the future with respect to the assigned topic. The goal of each presentation is to review the pertinent available data but, as importantly, to discuss the topic in terms of new and upcoming strategies.
  • Remember that the on-site audience is composed of only the conference faculty, and, thus, there is no need to review basic material. All conference presenters are deemed experts in the field. However, the manuscript should be written for the readers of Respiratory Care.
  • One of the key goals of the presentation is to stimulate discussion. Controversial topics and perspectives are encouraged.
Instructions for Manuscripts
  • Unlike the presentation, the manuscript should be a comprehensive review of the assigned topic. Each manuscript should include a pertinent review of the available literature, the topics presented at the conference, and thoughts for the future care of adult patients with respect to the assigned topic.
  • Manuscripts should include a liberal use of figures and tables to illustrate key points and support the text.
  • It is vital to the success of the conference for the controversial nature of issues to be emphasized for the readers.

The discussion associated with each presentation will be audiotaped, transcribed, and published with their respective manuscripts. You will be able to edit your comments prior to publication.

Publication Timeline
June 2–3, 2020Conference held in St. Petersburg, FL
August 10Discussion transcripts sent to speakers for editing
August 24Edited discussion transcripts returned
September 1Submit manuscript
November 16Peer review complete
December 31Submission of revised manuscript
February 1, 2021 All manuscripts accepted
March 1Manuscripts to production
April 15All proof reviewed and revised
June, 2021Manuscripts and discussions published in the June 2020 issue of Respiratory Care

Tuesday, June 2

8:00 a.m.–8:15 a.m.

Overview, Introductions, Ground Rules
Neil MacIntyre, MeiLan Han, Tom Kallstrom


8:15 a.m.–8:45 a.m.

COPD Etiology, Pathophysiology and Definition
Jeffrey L Curtis MD, Ann Arbor, MI

What is the pathology and mechanisms of injury in the large airways, small airways and alveolar spaces? Are there common mechanisms in bronchitis and emphysema? Is there always airway narrowing or flow limitation? (ie does the “O” in COPD mean obstruction always present?) Conventional definition is exposure + abnormal spirometry + symptoms; Is it time for an expanded definition? What is the role of imaging?


8:45 a.m.–9:00 a.m.

Discussion of Dr. Curtis’s presentation


9:00 a.m. – 9:30 a.m.

COPD Phenotypes
Don Sin MD, Vancouver, BC

Are clinical phenotypes defined by symptomatology (cough/phlegm vs dyspnea; exacerbation tendency); physiology (spirometry, hyperinflation, DLCO, gas exchange); anatomy (visual – emphysema vs large airway vs small airway); metabolic (biomarkers)? What drives development of different phenotypes?


9:30 a.m.–9:45 a.m.

Discussion of Dr. Sin’s presentation


9:45 a.m.–10:00 a.m.

Break


10:00 a.m.–10:30 a.m.

Early COPD and Natural History
MeiLan K Han MD MSc, University of Michigan

Can this be described beyond the traditional Fletcher Pito diagram? Are small airway changes always a precursor of overt COPD? Are phenotype differences important in disease trajectory and outcome? What is the role of imaging, symptoms, and biomarkers?


10:30 a.m.–10:45 a.m.

Discussion of Dr. Han’s presentation


10:45 a.m.–11:15 a.m.

The Role of PFT in Diagnosis and Management of COPD
Jeffrey M Haynes RRT RPFT FAARC, Nashua, NH

What are the roles of spirometry, diffusing capacity, and exercise testing? Why might spirometry may not be enough to make the diagnosis? What is the role of case finding in COPD and screening approaches?


 11:15 a.m.–11:30 a.m.

Discussion of Mr. Haynes’ presentation


11:30 a.m.–2:00 p.m.

Recess
On your own.


2:00 p.m.–2:30 p.m.

The Functional and Psycho-social Consequences of COPD
Anne Mathews MD

How do chronic illness and anxiety/depression affect individuals with COPD? What is the impact of COPD on QOL? What are the pharmacological and non-pharmacological approaches to management?


2:30 p.m.–2:45 p.m.

Discussion of Dr. Mathew’s presentation


2:45 p.m.–3:15 p.m.

Novel COPD Pharmacologic Therapies
James F Donohue MD, Chapel Hill, NC

What are the roles of beta-agonists versus muscarinic antagonists versus ICS in COPD? What is the role of combos: SABA/SAMA, LAMA/LABA, LAMA/LABA/ICS? Are current GOLD and COPD Foundation guidelines enough? What is the role of biologics and anti-inflammatory approaches (azithro, roflumilast)? How do eosinophils and smoking play into choice of medications.


3:15 p.m.–3:30 p.m.

Discussion of Dr. Donohue’s presentation


3:30 p.m.–3:45 p.m.

Break


3:45 p.m.–4:15 p.m.

Surgical Approaches
Gerald J Criner MD, Temple University

What is the current status of LVRS in patients with COPD? When should valves be used? What about carotid body resection? When is lung transplantation appropriate for the patient with COPD?


4:15 p.m.–4:30 p.m.

Discussion of Dr. Criner’s presentation


4:30 p.m.–5:00 p.m.

Prevention and Management of COPD Exacerbations
Brian W Carlin MD FAARC, Ingomar, PA

What medications are appropriate for a COPD exacerbation? What are the roles of rehabilitation, telemedicine and home visits to prevent and manage exacerbations? What is the role of patient action plans? How can inpatient navigators help?


5:00 p.m.–5:15 p.m.

Discussion of Dr. Carlin’s presentation


5:15 p.m.

Recess
Until 8:00 a.m. Wednesday morning.


6:00 p.m.–7:00 p.m.

Reception
In the Mezzanine. Families and friends are welcome.

Wednesday, June 3

8:00 a.m.–8:30 a.m.

Respiratory Failure in COPD
Neil R MacIntyre MD FAARC, Duke University

What is appropriate pharmacology (beta agonists, muscarinic antagonists, antibiotics, steroids)? When to intubate? How to best manage invasive mechanical ventilation? What is the role of ECMO (including ECCO2R)?


8:30 a.m.–8:45 a.m.

Discussion of Dr. MacIntyre’s presentation


8:45 a.m.–9:15 a.m.

Pulmonary Rehabilitation for COPD
Trina M Limberg RRT FAARC, San Diego, CA

What is the current evidence supporting rehabilitation? How can barriers to conventional programs be overcome? What is the role of non-traditional approaches such as home programs and telemedicine?


9:15 a.m.–9:30 a.m.

Discussion of Ms. Limberg’s presentation


9:30 a.m.–9:45 a.m.

Break


9:45 a.m.–10:15 a.m.

Oxygen Therapy
Thomas J Kallstrom MBA RRT FAARC

What are the benefits for oxygen in patients with COPD? How is a patient qualifying for home oxygen? How does one select an appropriate device? When should oxygen be prescribed during sleep and exercise? What are the reimbursement issues?


10:15 a.m.–10:30 a.m.

Discussion of Mr. Kallstrom’s presentation


10:30 a.m.–11:00 a.m.

Noninvasive Ventilation for COPD
Robert Owens MD, San Diego, CA

What is the evidence supporting NIV for COPD exacerbation? Can NIV be used to facilitate earlier extubation of patients with COPD? What is the role of NIV in the stable patient with COPD and chronic hypercapnia? When, if ever, should high intensity NIV be used for stable patients with COPD?


11:00 a.m.–11:15 a.m.

Discussion of Dr. Owens’ presentation


11:15 a.m.

Adjourn

Faculty

Jeffrey L Curtis MD
University of Michigan
Taubman Center Floor 3 Reception C
1500 E Medical Center Dr SPC 5360
Ann Arbor, MI 48109
jlcurtis@umich.edu

Brian W Carlin MD FAARC
Sleep Medicine and Lung Health Consultants
PO Box 174
Ingomar, PA 15127
bwcmd@yahoo.com

Gerard J Criner MD
Pulmonary and Critical Care Medicine
845 Parkinson Pavilion
Temple University Hospital
3401 N Broad Street
Philadelphia PA 19140
Gerard.Criner@tuhs.temple.edu

James F. Donohue, MD
UNC Hospitals Pulmonary Specialty Clinic
300 Meadowmont Village Circle
Suite 203
Chapel Hill, NC  27517
jdonohue@med.unc.edu

MeiLan K Han MD MSc
University of Michigan
1500 East Medical Center Drive, TC 3916
Ann Arbor, MI 48109
mrking@umich.edu

Jeffrey M Haynes RRT RPFT FAARC
Pulmonary Function Laboratory
St Joseph Hospital
172 Kinsley Street
Nashua, NH 03060
jhaynes@sjhnh.org

Thomas J Kallstrom MBA RRT FAARC
CEO and Executive Director, AARC
Irving, TX
kallstrom@aarc.org

Trina M Limberg RRT FAARC
Pulmonary Rehabilitation
University of California, San Diego
tlimberg@ucsd.edu

Anne Mathews MD
Pulmonary and Critical Care Medicine
Duke University Medical Center, Box 3911
Durham, NC 27710
anne.mathews@duke.edu

Neil R MacIntyre MD FAARC
Pulmonary and Critical Care Medicine
Duke University Medical Center, Box 3911
Durham, NC 27710
neil.macintyre@duke.edu

Don Sin MD
Centre for Heart Lung Innovation
Room 166, 1081 Burrard Street
Vancouver, BC V6Z 1Y6
Don.Sin@hli.ubc.ca

Robert Owens MD
Pulmonary, Critical Care, and Sleep Medicine
University of California, San Diego
4520 Executive Drive, Suite P2
San Diego, CA 92121
rowens@ucsd.edu

Journal and AARC Staff

Richard D Branson MSc RRT FAARC
Editor-In-Chief, Respiratory Care
branson@aarc.org

Dean R Hess PhD RRT FAARC
Managing Editor, Respiratory Care
dhess@aarc.org

Sara F Moore
Assistant Editor, Respiratory Care
sara.moore@aarc.org

Thomas J Kallstrom MBA RRT FAARC
CEO and Executive Director, AARC
kallstrom@aarc.org

Timothy R. Myers MBA RRT-NPS FAARC
Chief Business Officer, AARC
myers@aarc.org