The Society’s Assembly on Pulmonary Rehabilitation (PR) is coming into its own at the 2010 ATS International Conference.

As the newest ATS assembly, the Assembly on PR is presenting a top-notch array of sessions that will display the depth and breadth of clinical knowledge that is being brought to bear in treating chronic respiratory disease using a multi-disciplinary approach.

According to assembly chair Suzanne C. Lareau, R.N., M.S., a senior instructor at the University of Colorado Denver College of Nursing, the Assembly on PR is sponsoring four sessions during ATS 2010:

A85: “Challenges and Opportunities in Pulmonary Rehabilitation” (today from 1:30 to 4 p.m.)

C1: “Year in Review: Pulmonary Rehabilitation” (Tuesday from 8:15 to 10:15 a.m.)

D3: “Thomas Petty Memorial Symposium: Treating COPD by Not Treating the Lungs: What and How to Treat Co-Morbidities” (Wednesday from 8:15 to 10:45 a.m.)

D6: “Beyond COPD: Benefits and Challenges of Pulmonary Rehabilitation for Other Chronic Respiratory Diseases” (Wednesday from 8:15 to 10:45 a.m.)

“Pulmonary rehabilitation has historically been the go-to treatment for COPD patients, although it has also been used in the
treatment of asthma and cystic fibrosis, as well as a number of other disorders,” Ms. Lareau said. “The focus of these sessions will be on what we know, what we don’t know and what we need to do to learn more.”

Today’s “Challenges and Opportunities in Pulmonary Rehabilitation” session will address the growing belief that COPD is connected to many chronic illnesses.

“Patients seldom present with just one disorder,” said Richard Casaburi, M.D., Ph.D., who is professor and associate chief in the Division of Respiratory and Critical Care, Physiology and Medicine at the Los Angeles Biomedical Research Institute, who will co-chair the session with E. Neil Schachter, M.D. “COPD is a multi-system disease, and co-morbid conditions are common. This symposium will help the practitioner deal with the complexities of treating such patients.”

COPD patients have eight times the risk of congestive heart failure, as well as an increased incidence of myocardial infarction, diabetes, depression, osteoporosis and cataracts, and 2.5 times the risk of lung cancer compared with people with normal lung function.

“It has been known for several years now that COPD patients are prone to a number of co-morbidities,” said Dr. Schachter, who is professor of medicine and community medicine and the medical director of the Respiratory Care Department at Mount Sinai Medical Center in New York. “Most of these chronic diseases seem to be manifesting in what looks like a systemic inflammatory state. In other words, the inflammation is probably one of the driving forces in each of these diseases, sort of a feedback loop where the inflammation makes it more likely that these disorders are going to be concurrent because each one is feeding off the other.”

The challenge, Dr. Schachter added, is to translate this knowledge from an anecdotal to a quantifiable category.

“For years, I would look at a COPD patient’s chart and see a litany of other chronic diseases listed there,” he continued. “That’s more than just a coincidence. The corollary is that because there is a concurrence of diseases, there is a high likelihood that complications in a patient with COPD may actually be caused by a related disease. It is clear from the epidemiology that most COPD patients get sick not only from COPD, but also get sick and die from these other diseases.”

Dr. Schachter said that the session brings together a group of expert pulmonologists who have an interest in a specific co-morbidity.

“Each talk will suggest some strategy to better manage the patient through pulmonary rehabilitation,” he said. “PR brings us closer to patients and allows more time than the average visit in the doctor’s office to manage and direct these patients with various co-morbidities.”