59th RESPIRATORY CARE Journal Conference

 

COPD: Current Evidence and Implications for Practice

June 21–22, 2022

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

Neil R MacIntyre MD FAARC
MeiLan K Han MD Msc
Conference Co-chairs

Presented under the auspices of the

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

Tuesday, June 21

8:00 a.m.–8:15 a.m.

Overview, Introductions, Ground Rules
Neil MacIntyre, MeiLan Han

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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?

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8:45 a.m.–9:00 a.m.

Discussion of Dr. Curtis’s presentation

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9:00 a.m. – 9:30 a.m.

COPD Phenotypes
Stephanie Christenson MD MAS, San Francisco, CA

Clinical phenotypes can be 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?

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9:30 a.m.–9:45 a.m.

Discussion of Dr. Christenson’s presentation

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9:45 a.m.–10:00 a.m.

Break

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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?

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10:30 a.m.–10:45 a.m.

Discussion of Dr. Han’s presentation

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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?

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 11:15 a.m.–11:30 a.m.

Discussion of Mr. Haynes’ presentation

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11:30 a.m.–2:00 p.m.

Recess
On your own.

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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?

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2:30 p.m.–2:45 p.m.

Discussion of Dr. Mathew’s presentation

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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.

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3:15 p.m.–3:30 p.m.

Discussion of Dr. Donohue’s presentation

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3:30 p.m.–3:45 p.m.

Break

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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?

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4:15 p.m.–4:30 p.m.

Discussion of Dr. Criner’s presentation

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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?

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5:00 p.m.–5:15 p.m.

Discussion of Dr. Carlin’s presentation

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5:15 p.m.

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

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6:00 p.m.–7:00 p.m.

Reception
In the Mezzanine. Families and friends are welcome.

Wednesday, June 22

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)?

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8:30 a.m.–8:45 a.m.

Discussion of Dr. MacIntyre’s presentation

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8:45 a.m.–9:15 a.m.

Pulmonary Rehabilitation for COPD
Chris Garvey FNP, MSN, MPA, MAACVPR, San Francisco, 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?

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9:15 a.m.–9:30 a.m.

Discussion of presentation

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9:30 a.m.–9:45 a.m.

Break

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9:45 a.m.–10:15 a.m.

Oxygen Therapy
TBA

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?

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10:15 a.m.–10:30 a.m.

Discussion of Oxygen Therapy presentation

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10:30 a.m.–11:00 a.m.

Noninvasive Ventilation for COPD
Jeremy E Orr 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?

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11:00 a.m.–11:15 a.m.

Discussion of Dr. Orr’s presentation

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11:15 a.m.

Adjourn

Faculty

Journal and AARC Staff