One of the great strengths of the ATS International Conference is that it’s multidisciplinary. Throughout ATS 2012, you can immerse yourself in a wealth of offerings within the Society’s three pillars—pulmonary, critical care and sleep medicine. Whether you choose topics in all three pillars or choose to focus on just one pillar, ATS 2012 offers the latest trends in treatment, leading to improved patient care. What follows is a selection of programming in pulmonary, critical care and sleep medicine slated for today and Wednesday.
PULMONARY SESSIONS
TUESDAY
8:15 to 10:45 a.m.
C5 Revisiting the IDSA-ATS Community-Acquired Pneumonia Guidelines: Five Years Older, but Any Wiser?
Rooms 3000-3002-3004, West Building (Level 3), Moscone Center
Five years after finalizing the 2007 IDSA (Infections Disease Society of America)-ATS community-acquired pneumonia guidelines, much new research has been published. Since no guideline update has been initiated, reviewing what is new in the field is important for clinicians, researchers and those tasked with improving pneumonia care. This seminar addresses key elements of the guideline where new information and insights are available. Three of the presenters were members of the 2007 guideline committee; the other three are younger ATS members who have made important contributions to this field since 2007.
8:15 to 10:45 a.m.
C7 Developmental Control of Respiratory Structure and Function During the Course of Life
Rooms 3016-3018, West Building (Level 3), Moscone Center
Accumulating evidence indicates lung development in utero and in early childhood determine lung function in later life. Furthermore, it has been postulated that gene-environment interactions, antenatally and in the first years of life, are pivotal for the progression to chronic airways disease later in life. However, the precise effects of these risk factors on early development of airway and lung structure and their impact on remodeling and lung function later in life are unclear. This symposium aims to connect development of the lung to disease susceptibility and progression later in life with emphasis on structural remodeling and lung function.
8:15 to 10:45 a.m.
C10 Implementing Lung Cancer Screening: Moving From RCTs to the Real World
Rooms 132-133, North Building (Lower Level), Moscone Center
Lung cancer screening holds the promise to dramatically reduce mortality but implementing screening programs in the real world will be challenging as medical centers attempt to design programs that maximize fidelity to capitalize on benefits
(lower lung cancer mortality) while minimizing potential downsides (false positives, complications of work-up, excessive costs). This session will address key questions such as: results of clinical trials, cost-effectiveness and which individuals to screen, communicating risks and benefits of screening with patients, how to manage pulmonary nodules, overcoming barriers to screening, and how to incorporate newer technologies to manage patients.
2 to 4:30 p.m.
C89 Evidence-Based Innovations in Tuberculosis Diagnosis and Treatment
Rooms 3020-3022, West Building (Level 3), Moscone Center
Technologic, pharmacologic and programmatic innovations in the last few years offer the prospect of significant impact on diagnosis and treatment of tuberculosis. New tuberculosis drugs are undergoing clinical trials but pathways for testing these drugs in new regimens need to be developed with limited resources to meet urgent clinical needs. As innovations in TB diagnostics and treatment become available, their use should be optimized in order to create the most impact in reducing the burden of this disease. Participants will apply new knowledge of TB diagnostics to his/her practice or improve the quality of health of patients; learn new findings about drug susceptible and drug resistant TB management; and gain new strategies to manage the care of patients with drug susceptible and resistant TB.
WEDNESDAY
2 to 4:30 p.m.
D86 Impact of Exercise on Cardiopulmonary Status: Implications for Pulmonary Hypertension
Rooms 3000-3002-3004, West Building (Level 3), Moscone Center
The role of exercise in the diagnosis of pulmonary hypertension (PH) is controversial, as are the benefits of exercise training in this disease. Presentations in this symposium will first review the impact of exercise on cardiopulmonary status, including right ventricular function, pulmonary hemodynamics and ventricular-vascular coupling. Then speakers will present current perspectives on the role of exercise in diagnosing and making prognoses for PH, methods for measuring exercise capacity and the potential benefits of exercise training for treatment of PH. Finally, the special case of exercise in scleroderma-related PAH will be discussed
CRITICAL CARE SESSIONS
TUESDAY
8:15 to 10:45 a.m.
C4 Acute Kidney Injury in the Intensive Care Unit
Rooms 303-305-307, South Building (Esplanade Level), Moscone Center
Many intensive care unit patients develop acute kidney injury during their hospitalizations, a condition which impacts on short- and long-term outcomes and on ICU resources utilization. This session will focus on current evidence regarding acute kidney injury diagnosis, prognosis and treatment in the critical care setting.
8:15 to 10:30 a.m.
C14 Clinical Trials in Critical Care
Room 304-306, South Building (Esplanade Level), Moscone Center
After a discussion on whether the right outcomes are being measured, speakers at this mini-symposium will describe seven trials: “SLEAP: A Multicenter Randomized Trial of Daily Awakening in Critically Ill Patients Being Managed With a Sedation Protocol,” “Adjuvant Rapamycin Improves the Outcomes of Severe H1N1 Pneumonia and Acute Respiratory Distress Syndrome,” “Understanding the Re-Consent Process for Critical Care Research: Results of an Observational Study and National Survey,” “Feasibility of an Early Physical and Cognitive Rehabilitation Protocol for Critically Ill Patients: The Activity and Cognitive Therapy in the ICU (ACT-ICU) Trial,” “Difficulties of Patient Recruitment to a Post-Critical Illness Rehabilitation Programme,” “Survivorship After Acute Lung Injury: Two-Year Health Care Resource Utilization and Costs,” and “Randomized Trial of Initial Trophic vs. Full Enteral Feeding in Patients With Acute Lung Injury (EDEN).”
2 to 4:30 p.m.
C84 Using Genomics to Understand and Treat Acute Lung Injury
Rooms 303-305-307, South Building (Esplanade Level), Moscone Center
With the completion of the Human Genome Project, genetic association studies are becoming increasingly prevalent yet increasingly complex. Despite the explosion of data, it remains difficult both to keep abreast of the technological advances and to visualize how these advances might impact clinical care. This session will review the state of the art of genomic acute lung injury investigations at both the clinical and translational level, and it will provide insight as to where genomic medicine may allow for personalized ALI therapy in the future.
WEDNESDAY
8:15 to 10:45 a.m.
D4 Intensive Care of the Future
Rooms 303-305-307, South Building (Esplanade Level), Moscone Center
With evolving technology and patient populations, intensive care is a field that is changing rapidly. Planning for future care requires discussion of what changes to expect and how the delivery of care may be altered. This session seeks to explore a number of areas of critical care that may change dramatically in the near future, including staffing patterns, technology and medications, and other resources. Attendees will gain knowledge that will allow them to plan for adoption of new practices.
SLEEP SESSIONS
TUESDAY
8:15 to 10:45 a.m.
C8 No Pain No Gain: Will Upper Airway Exercise Training/Electrical Stimulation Work for Sleep Apnea?
Rooms 3001-3003, West Building (Level 3), Moscone Center
This session will address some of the recent novel findings demonstrating reductions in sleep apnea severity with upper airway muscle training/stimulation techniques. Specifically, the session will cover various aspects of this approach including likely mechanisms of improvement, which patients are most likely to benefit, which patients may get worse, and various aspects of upper airway/respiratory muscle physiology based on animal and human work.
11:30 a.m. to 1 p.m.
WS5 Models of Sleep Apnea Care Utilizing Portable Monitoring and Alternative Delivery Methods
Room 301, South Building (Esplanade Level), Moscone Center
Registration Fee: $75.00 (includes box lunch.)
Attendance is limited. Pre-registration is required.
Traditional management of sleep-disordered breathing has focused on diagnostic testing and implementation of therapy utilizing attended polysomnography. However, more efficient care models are necessary to provide better access to care (especially in the developing world), limit health care costs and improve outcomes with a focus on follow-up care. Presenters describe three health care systems (Kaiser Permanente, the U.S. Department of Veterans Affairs, Adelaide Institute for Sleep Health- Australia) as potential models for alternative delivery of care utilizing portable monitoring, different methods of follow-up care (based on use of non-physician providers) and implementation of new technologies to enhance workflow efficiency.
2 to 4:30 p.m.
C87 Hypoxia and Neurocognitive Impairment: Lessons From Sleep Apnea and Ischemic Brain Injury
Rooms 3006-3008, West Building (Level 3), Moscone Center
Neurocognitive effects of hypoxia will be examined using obstructive sleep apnea and ischemic brain injury as models. This session will highlight the impact of obstructive sleep apnea syndrome on neurocognitive function in children and adults. The molecular mechanisms by which neurocognitive impairment occurs will be reviewed. Recent advances in understanding the disease pathophysiology, especially involving the use of functional and structural neuroimaging techniques will also be discussed. Tests by which neurocognitive function can be assessed as well as future research questions in this area will be highlighted.
WEDNESDAY
8:15 to 10:45 a.m.
D18 Sleep-Disordered Breathing and Metabolic Function: How Unsweet It Is
Rooms 3020-3022, West Building (Level 3), Moscone Center
Among the nine abstract presentations in this mini-symposium will be the results of the European Sleep Cohort Study, which enrolled 7,886 patients from throughout Europe. Researchers found that, after rigorously controlling for obesity and other confounding variables, both obstructive sleep apnea syndrome severity and hypoxemia were independent predictors of both diabetes mellitus and of HbA1c, a “robust predictor” of subsequent cardiovascular mortality in non-diabetic populations.
2 to 4:30 p.m.
D87 Intermittent Hypoxia Mediated Cardiovascular and Neuronal Protective Mechanisms
Rooms 3005-3007, West Building (Level 3), Moscone Center
This symposium will highlight an important and generally less known aspect of intermittent hypoxia (IH), namely, the induction of protective mechanisms in the heart and neuroplasticity. These mechanisms distinctly differ from the IH’s well-established deleterious effects. Attendees will gain an overview on molecular mechanisms of ischemia/reperfusion inducing ischemic preconditioning in the heart and neuronal plasticity, and learn about translational studies in animal models and humans. A discussion will be devoted to possible clinical implications of IH as a potential therapeutic modality in cardio-neuronal injury and its possible effects in explaining paradoxical findings on mortality of elderly sleep apnea patients.