Program and Featured Sessions

Program and Featured Sessions

Dozens of live and prerecorded education sessions

October 18–21, 2020

CHEST 2020 has been reimagined to feature a variety of live and pre-recorded education sessions led by top-tier faculty who will bring you the latest in clinical developments related to the pulmonary, critical care, and sleep medicine fields, with numerous opportunities for Q&A. This is your opportunity to be one of the first to experience CHEST simulation through demonstration videos that will feature polling questions to gauge understanding and guide discussion points.

Personalize Your Experience

VIEW THE CHEST 2020 AGENDA

KEYNOTE ADDRESS

Anthony Fauci, MD

Sunday, October 18, 2020
8:45 AM – 9:45 AM CT

CHEST 2020 Opening Session

We are pleased to announce that Dr. Anthony Fauci will be giving the CHEST 2020 keynote address. As the director of the National Institute of Allergy and Infectious Diseases (NIAID) at the US National Institutes of Health, his insight into the COVID-19 pandemic will be invaluable.

Topics you can expect him to address include:

  • Current clinical guidelines and research for treating COVID-19
  • What to expect if/when a second wave hits
  • How to fight resurgence of a pandemic

Dr. Fauci has been instrumental in sorting through the latest clinical data on COVID-19, discerning what’s been backed by credible research and what hasn’t. We believe this is a key component in helping all of us make the best decisions for our patients – a critical component of CHEST’s mission.

Dr. Fauci’s address will be prerecorded. To ensure this segment of our event is as interactive and immersive as possible, there will be a live panel/Q&A discussion immediately following with CHEST President-Elect Steven Q. Simpson, MD, FCCP; Mangala Narasimhan, DO, FCCP; and Ryan Maves, MD, FCCP. CHEST President, Stephanie Levine, MD, FCCP, will serve as moderator.

The Opening Session will also include

  • A Message from Victor J. Test, MD, FCCP, Chair, 2020 Annual Meeting
  • Presidential Address by Stephanie Levine, MD, FCCP
  • Message from CHEST Foundation President Edward Diamond, MD, MBA, FCCP
  • Annual Awards Recognition
Stephanie Levine

Stephanie Levine, MD, FCCP

Edward Diamond

Edward Diamond, MD, MBA, FCCP

Featured Sessions Not to Miss

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Featured sessions are your opportunity to hear from the top experts, pioneers, and researchers in chest medicine. We’re bringing you the most cutting-edge topics in clinical education. These are the sessions that the Annual Meeting is known for – exclusive, compelling, and relevant.

COVID-19 icon

COVID-19 will be front and center at CHEST 2020 highlighting crucial and quickly evolving information, including complications with COVID-19 recovery, COVID-19 management in complex situations, and additional discussions on updated drug trials, treatment plans, and practice management changes.

Experts icon

Experts from across the field will bring you the latest in clinical developments related to the diagnosis, treatment, and management of pulmonary diseases, critical care complications, and sleep disorders. Nonclinical topics, like cultural diversity and burnout, will be prominent at CHEST 2020.

CHEST 2020 Daily News

Stay up to date before, during, and after CHEST 2020 by visiting the meeting’s official online news source. Read previews of some of each day’s most anticipated sessions and live coverage of virtual presentations, watch videos, and check back after the meeting for continued coverage.

Visit CHESTDailyNews.org »

CHEST Daily News

Event Calendar – Personalize your agenda

Every day at CHEST 2020 is sure to have sessions that you’ll want to attend. You’ll be able to personalize your experience by planning to engage with the content that you want to watch. All live session recordings will be available for viewing the following day.

VIEW THE CHEST 2020 AGENDA

On-Demand Prerecorded Sessions – Listen anytime, anywhere

If live sessions don’t fit your schedule, you can still experience the content you want at CHEST 2020. With dozens to choose from, prerecorded sessions are easy to start and stop when it is convenient for you. View the full list of the CHEST 2020 on-demand prerecorded sessions below.

NetWork Bites: Airway Disorders

CHEST ID: 7010

Beyond Spirometry: New Developments in the Diagnosis and Assessment of Asthma

“Asthma is a heterogeneous disease in which spirometry continues to be key part of the diagnosis and assessment. Over the past several years, newer tools have been developed to aid in the evaluation, follow-up, and treatment of asthmatics, particularly in severe disease. The peripheral eosinophils, IgE, and fractional exhaled nitric oxide (FeNO) have been shown to predict responsiveness to specific biologicals, but controversy exist regarding how to best select therapy when patients meet more than one criteria for treatment. There has been further understanding of when to implement imaging in asthma, and recent advancements have been made to better characterize patients using CT. Bronchoprovocation testing can improve the diagnostic accuracy of asthma, but it is often underutilized.”

CHEST ID: 2054

American Association for Bronchology and Interventional Pulmonology: Benign Central Airway Obstruction. Do We Need a Multidisciplinary Approach for This “Benign” Disease?

We will review the most common cause of benign airway obstruction, the complexity of this disorder, and the need for a multidisciplinary team for the best treatment options.

CHEST ID: 2155

Evolving Paradigms in the Selection of Biologicals for Severe Asthma

An important proportion of asthmatics have uncontrolled symptoms despite the use of high-dose inhaled steroids and long-acting bronchodilators. There are now several approved monoclonal antibodies for the treatment of these patients, including home-use options. Yet the selection among these therapies can be challenging and, although clinicians can use “treatable traits” to better predict favorable responses, other factors have to be considered. The session will consist of a discussion of the approach to selection of biologicals for severe asthma using phenotypical characteristics and other features to determine the best therapy. Format: six to eight cases with an audience response.

CHEST ID: 24543

Treatment of Status Asthmaticus

The treatment of status asthamticus is complex and includes optimal delivery of bronchodiolators, noninvasive mechanical ventilation, and corticosteroids. New studies and guidelines have been published to support an evidence-based approach to treating these severely ill patients. Strategies for mechanical ventilation should by based on the physiology of severe obstruction and an indepth knowledge of drugs used for sedation/paralysis is essential. Adjunctive therapy, including ECMO, may be required in patients who fail to respnd to standard therapy. This lecture will address each of these issues and bring the audience up to date on caring for asthma in the ICU.

CHEST ID: 24652

Bronchiectasis: Beyond Cystic Fibrosis

Non-cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. Early diagnosis and determination of the extent and severity of the disease is essential to initiate therapy to improve quality of life and help slow progressive decline of lung function.

CHEST ID: 24863

Society of Thoracic Surgeons: The Ground Glass Lesion. Indolent or Deadly?

Evolving concepts in the definition of the patient with a lung nodule at high risk for complications from interventions will be explored.

CHEST ID: 2164

Management of Cardiothoracic Surgery Patients in the ICU: Issues and Outcomes

The care of the perioperative care of the cardiothoracic surgery patient has significant challenges that are different from other critically ill populations. The intensivist must understand how operative strategies (eg, cardiac bypass, cardioplegia, and single lung ventilation) play a role in the immediate postoperative recovery period, especially as these strategies relate to cardiopulmonary physiology and coagulopathy. This session will review the care of the cardiothoracic surgery patient, specifically focusing on the early postoperative and intraoperative periods. Inotropic, vasopressor, and respiratory support, as well as postoperative bleeding, will be discussed.

CHEST ID: 24246

Postoperative Management of Cardiovascular Surgery Patients

Management of cardiovascular surgery patients in a quartenary referral center can be quite complex. We intend to discuss the management of hemodynamic complications, specifically vasopegia, bleeding complications, and the management of postoperative pain with the use of ERACS recovery system.

CHEST ID: 24717

Pump It Up! Percutaneous Mechanical Support Devices in Cardiogenic Shock

Cardiogenic shock after acute myocardial infarction requires immediate resuscitative therapy to prevent irreversible organ damage. The concept of establishing ventricular support prior to revascularization stresses the notion that unloading the left ventricle is key to its recovery. Various percutaneous devices for mechanical support have different effects on left ventricular afterload and myocardial oxygen demand. An understanding of the advantages and disadvantages of these devices helps the clinician to select the right device in the right setting.

CHEST ID: 24026

Acute Right Ventricular Failure. Is It the Worst Failure to Have?

Acute right ventricular failure is a rapidly progressive syndrome with systemic congestion resulting from impaired filling and/or reduced flow output. Research efforts have disproportionately focused on the failing left ventricle, but more attention has been placed on understanding the RV. It is a heterogeneous syndrome, and its varied etiologies require individualized treatment. This review will try to identify the efficacy and safety of pharmacological and mechanical interventions for the treatment of acute RV failure, in view of the high morbidity and mortality carried by this overlooked condition.

CHEST ID: 24115

Percutaneous Mechanical Support Devices in Cardiogenic Shock – How to Assess With Cardiac Ultrasound

Mechanical circulatory support (MCS) encompasses a range of cardiac assist systems that provide hemodynamic support in cardiogenic shock. Each MCS system has unique mechanical properties that impact clinical utilization, efficacy, and safety. This session will highlight the use of echocardiography in the peri-implantation evaluation of patients receiving MCS to guide device selection, hemodynamic optimization, and individual patient outcome.

CHEST ID: 24864

NetWork Bites: Cardiovascular Medicine and Surgery

CHEST ID: 7010

Another Respiratory Virus Winter Season?

“This session will explore multiple aspects of respiratory infection from epidemiology through specific seasonal and pandemic viruses, clinical presentation, their role in acute and chronic lung diseases, and treatment and prevention. Respiratory viral infections continue to be a major global health problem affecting all ages, particularly affecting the very young children and elderly populations. Respiratory viruses are the most commonly detected causes of community-acquired pneumonia and respiratory tract infections. Over the past decades, important advances in the understanding of epidemiology and prevalence of these pathogens have emerged and changed the perception of these pathogens. Molecular-based nucleic acid detection has become the standard diagnostic method for respiratory viral pathogens, having replaced older serologic and antigen-detection methods. Current available antiviral therapies for some respiratory viral infections will be described. Finally, preventive strategies, including immunization directed to limited number of respiratory pathogens, will be reviewed”

CHEST ID: 2051

Changing Landscape of Tuberculosis in the US – Update on Epidemiology and Novel Developments

Despite declining rates, TB remains an important health issue in the US. The session provides an update on:Current epidemiology of TB in the US including influence by immigration and aging population.Novel developments in diagnosis and susceptibility testing that will have a direct impact on management with early diagnosis and decreased turnaround time for implementation of an appropriate regimen.Identification and management LTBI with focus on people at increased risk for developing active disease, exposure prophylaxis for MDRTB.TB survivors with structural lung disease are prone to develop impaired lung function, infections such as aspergilloma, bronchiectasis or NTM.

CHEST ID: 24356

Tuberculosis: New Challenges and New Therapies in the Era of Drug Resistance

There are an estimated 10 million newly diagnosed cases of tuberculosis (TB) worldwide per year. Of the 500,000 prevalent cases of multidrug-resistant and rifampin-resistant tuberculosis (MDR/RR-TB), nearly half of these patients will die. New therapies and preventive strategies for MDR/RR-TB have the potential to reduce the morbidity and mortality of this disease. In this session, we will review the global epidemiology of MDR/RR-TB, novel methods for disease prevention, and modern strategies for drug therapy, including the repurposed use of older medications for TB treatment as well as novel agents, such as bedaquiline and pretonamid.

CHEST ID: 24478

New CAP Guidelines – What Changed?

This session will review the most relevant changes and key messages of the 2019 Clinical Practice Guidelines (CPG) Community-Acquired Pneumonia (CAP) published by the American Thoracic Society and the Infectious Diseases Society of America (ATS/IDSA). This session will address three important areas of change: 1) Definition, epidemiology and risk factors; 2) Diagnosis of bacterial and viral pathogens; and 3) Treatment of patients with CAP.

CHEST ID: 24608

Treating NTM lung Infections Based on the 2020 Guidelines

This session will use a case-based approach to illustrate the impact of the new ATS/ISDA guidelines on the treatment of nontuberculous mycobacterial lung infections.

CHEST ID: 24665

Optimal Therapy for Patients With Bronchiectasis: Pro/Con Debate

In this session optimal treatments for patients with bronchiectasis will be debated in two pro/con sessions.

CHEST ID: 24674

Opportunistic Pneumonias in Immunocompromised Hosts: Understanding the Risk in Non-HIV Patients

Opportunistic infections kill more than 1.5 million people globally each year. Secondary to advances in immunotherapy for various disorders, the number of at-risk, immunocompromised persons is increasing. However, not all immune-modulating medications have the same risk for causing opportunistic infections, and some medications may predispose to different organisms. Moreover pneumonias caused by opportunistic fungi, bacteria, and viruses have a high mortality rate; successful patient outcomes hinge on prevention and early diagnosis. Providers should be aware of the indications for pharmacologic prophylaxis, the types of infections associated with different immune-modulating medications, and the diagnostic limitations caused by pharmacologic prophylaxis.

CHEST ID: 24747

NetWork Bites: Chest Infections

CHEST ID: 7010

Critical Care Year in Review – I

This session will give the learner insights into new developments in sepsis, nonpulmonary critical care, mechanical ventialtion, and respiratory support. This session has been held for several years to an overflow crowd of participants and is a continuation of this annual presentation.

CHEST ID: 23954

Critical Care Year in Review – II

This session will inform the attendee about new advances in neurocritical care, ICU infections, and ARDS. This annual session is well attended by a highly engaged particpant audience.

CHEST ID: 23955

Ventilator Liberation: An Evidence-based Approach

Attendees will learn evidence-based approaches for liberating patients from mechanical ventilation. This session will be based on recommendations published in CHEST guidelines.

CHEST ID: 23956

When, What, and How Much Should I Feed My Critically Ill Patient?

Critical illness is associated with gut dysfunction, sarcopenia, calorie deficits, and acquired malnutrition. Furthermore, critical illness survivorship is met with functional limitations. Therefore, nutrition during critical illness serves to mitigate some of these complications. Contemporary randomized, controlled trials have shed light on optimal timing and dose of nutrition, method of delivery, and monitoring nutrition in critically ill patients. The objectives of this session will be to answer three key questions related to critical care nutrition: What is the optimal timing and dose to commence nutrition? When should I consider parenteral nutrition? and, What should I monitor during nutrition provision?

CHEST ID: 23975

Severe ARDS: New Frontiers in Management

Patients with severe ARDS challenge clinicians with their life-threatening illness and the complex strategies required for effective management. Attendees at this session will learn about the most recent research informing clinicians about management options in a case-based approach.

CHEST ID: 24053

“Remedies Oft in Ourselves Do Lie”: Endocrine Disorders and Critical Illness

This will be a case-based session where experts will present four cases of critically ill patients, each of which has an endocrine disorder as an important underlying feature of their illness. Attendees will learn about the differential diagnosis, clinical assessment, and treatment of patients with myxedema coma, adrenal insufficiency, hypoglycemia, and disorders of calcium metabolism.

CHEST ID: 24071

How Do You Say It? The Communication Tightrope in the ICU

Family-centered communication and integrated palliative care in the ICU practice setting can reduce acute stress for families. Structured communication is an important strategy to decrease family distress and the intensity of patient treatment; however, there is a substantial gap in the literature about how to translate communication improvements among the team and with families into clinical practice. The objectives of this session are to explore what is known about ICU communication, discuss the quality of current evidence to support practice, and apply this knowledge to a case study about a challenging end-of-life discussion.

CHEST ID: 24112

Identification and Treatment of ARDS: What Does the Future Hold?

ARDS is a common reason for ICU admission and has high morbidity and mortality. Unfortunately, published data suggest that the clinical recognition of ARDS is delayed and suboptimal. This session will discuss the challenges in identifying patients with ARDS and how emerging technologies, such as deep learning and natural language processing, can improve the identification of ARDS. It will then cover best practices once ARDS has been identified, followed by the discussion of how discovering novel subphenotypes of ARDS may enrich prognostic and predictive strategies for clinical trials.

CHEST ID: 24133

Bundles and Measures: Controversies in Sepsis Care

In recent years, the sepsis literature has evolved significantly: changes to the 3-hour surviving sepsis campaign (SSC) bundle to 1 hour and the creation of the sepsis core measure (SEP-1) and state mandate (New York). The changes to the SSC bundle raised controversy in the sepsis community and its implementation is currently on hold in the United States but not in Europe. The New York and CMS sepsis mandates have shown a positive effect on patient outcomes; however, there is resistance to their nationwide adoption. This session will include two debates from experts in the SSC bundle and core measures.

CHEST ID: 24242

Critical Hypoxemia in the Pregnant Patient: How Low Can You Go, and What To Do About It

Severe hypoxemia in pregnancy represents a life-threatening emergency for mother and fetus. Although hypoxemia may be due to a variety of causes in pregnancy, there is uncertainty as to what tolerable limits may be, and minimal evidence to guide management. This session will look at maternal/placental/fetal physiology to help understand the impact of maternal hypoxia on the fetus, and discuss critical hypoxaemia and its management in the very different settings of pulmonary embolism and ARDS. An obstetrician will discuss obstetric delivery as a potentially lifesaving intervention in these circumstances for both mother and baby. The audience-response system will be utilized.

CHEST ID: 24277

A Systematic Approach to the Management of Massive Hemoptysis

Massive hemoptysis remain the dreadful situation in clinical medicine that every airway doctor would like to avoid. Time is of the essence, and every second counts when it comes to the management of massive hemoptysis and a systematic approach is key to timely control. In three separate lectures, the presenters will discuss the etiology, stabilization, and management of massive hemoptysis. The goal is to provide the participants with the knowledge base and skill set required to take care of victims of massive hemoptysis.

CHEST ID: 24295

Brain Death for the Nonneurologic Intensivist

This session will cover the history and current state of neurologic criteria for death and its relation to organ donation. This will include a discussion on preparing families for the brain death evaluation, the criteria for determining brain death, and the coordination between intensivists and organ donation entities during this evaluation.

CHEST ID: 24392

Toxidromes and Overdose in the ICU Setting

Pattern recognition of toxidromes is important in identifying the agent and effecting timely intervention. Additionally, awareness of the newer agents of abuse, as well as emerging trends in management, may impact upon success in an acute poisoning encounter in emergency. This session will provide an overview of selected toxidromes of particular interest to medical intensive care clinicians.

CHEST ID: 24467

Cardiorespiratory Failure and Mechanical Circulatory Support. A Bootcamp for the Intensivist

Patients with cardiogenic shock and/or refractory acute respiratory failure continue to pose a significant dilemma for the intensivist, particularly in situations when conventional approaches fail. Overall assessment of refractory scenarios will be discussed. We will overview the most frequent indications for mechanical circulatory support (MCS) consideration and initiation strategies. We will review temporizing devices (IABP), basics of percutaneous and surgically implanted ventricular assist devices (temporary and permanent VADs), and extracorporeal membrane oxygenation (VA and VV ECMO) basics. Last, general strategies for ICU Care for the MCS patient will be discussed.

CHEST ID: 24486

Vaping-associated Respiratory Disease Syndromes (VARDS)

Exposure to vaping is associated with a growing list of respiratory syndromes, including an acute progressive form with life-threatening hypoxemic respiratory failure and pathological changes of lung injury defining VARDS. The reported spectrum of vaping-associated respiratory diseases allows clinical classification of cases into groups with distinct evaluation, management, and follow-up guidance. Clinical stratification also identifies a small proportion of vaping-exposed patients who are at risk for progression to hypoxemic respiratory failure and an ARDS-like illness.

CHEST ID: 24583

Extracorpeal Support in Critical Care: ECMO, VADs, and ECCO2R

The role of mechanical support devices in the management of critically ill patients has increased in the recent years. Extracorporeal membrane oxygenation (ECMO) is an established therapy in the management of patients with acute respiratory failure, with a growing number of centers providing ECMO services. The number of patients with ventricular assist devices (VADs) being cared for in the intensive care unit and emergency rooms is increasing. There is an evolving evidence regarding the role and impact of extracorporeal CO2 removal devices.

CHEST ID: 24723

Noninfectious Complications of Hematopoietic Stem Cell Transplantation

Allogeneic and autologous hematopoietic stem cell transplantation (HSCT) is increasingly used to treat a variety of malignant and nonmalignant conditions. Stem cell transplant patients are predisposed to a wide range of unique pulmonary and extrapulmonary complications that can lead to critical illness. As transplantation becomes more common, the wider community of pulmonary and critical care providers will be expected to manage these complications. We will use illustrative cases to discuss the pathophysiology, differential diagnosis, current best treatment practices, and latest scientific developments in key pulmonary and extrapulmonary complications that occur within the first several months following stem cell transplantation.

CHEST ID: 24727

Post-Code Blues: We Got ROSC! Now What?

Cardiac arrest is a devastating event that requires an immediate, coordinated response to achieve the return of spontaneous circulation (ROSC). The vast majority of clinicians are certified in Adult Cardiac Life Support (ACLS); however, few receive specific training on the rapidly evolving field of care of the post-ROSC patient. While targeted temperature management (TTM) justly receives much attention, optimization of other physiologic parameters may improve the likelihood of good outcomes after cardiac arrest and a thoughtful approach to neurological prognostication is warranted in all comers.

CHEST ID: 24743

Right Heart Cath Academy: Know Thy Swan Numbers and Waveforms

Accurate interpretation of swan ganz catheter-derived numbers is crucial to recognition of important hemodynamic derangements in critical care units. In small groups, we will hold discussions in a round-table format to recognize various abnormalities as it applies to different disease states, including common and uncommon patient conditions such as pulmonary arterial hypertension, left atrial hypertension, mixed cardiogenic and distributive shock, and shunt physiology. We will discuss practical issues including vein cannulation and catheter placement, possible pitfalls of catheterization, and interpretation of abnormal waveforms, and will review common calculations of pulmonary vascular resistance, transpulmonary gradient, and diastolic pulmonary gradients.

CHEST ID: 24786

Understanding DO2/VO2 in Shock: Don’t Abandon ScvO2!

We will review the fundamentals of oxygen transport and the balance between DO2 and VO2 in shock. We will discuss the hemodynamic phenotypes beyond vital signs, using endpoints of resuscitation such as ScvO2, lactate, and stroke volume variation. We will review the literature specific to the value of ScvO2 as a hemodynamic target and an outcome prognosticator in critically ill patients. We will share case examples to show the value of targeting ScvO2 at the bedside.

CHEST ID: 24811

Vasopressors and Corticosteroids: Controversies in Septic Shock

The current guidelines for the management of septic shock recommend norepinephrine as the first-line vasopressor. In patients with refractory shock, increasing doses of vasopressors are required. There is recent data that may support the addition of vasopressin as opposed to increasing the dose of norepinephrine. However, there is significant variability in practice. Corticosteroids have been a longstanding source of controversy in septic shock. Current guidelines recommend their use only in cases of hypotension refractory to fluids and vasopressors. Recent trials have shown conflicting results. This session will include two debates on both topics.

CHEST ID: 24893

NetWork Bites: Critical Care

CHEST ID: 7010

NetWork Bites: Home-Based Mechanical Ventilation and Neuromuscular Disease

CHEST ID: 7010

The Secondary Pulmonary Lobule and High-Resolution Patterns of Interstitial Lung Disease

This session will include a didactic discussion of the high-resolution anatomy of the secondary pulmonary lobule, followed by three clinical case presentations with imaging to reinforce the importance of this functional end unit of the lung for the diagnosis of ILD.

CHEST ID: 2058

Unusual Lung Disease: A Clinical Pathological Experience

This session will explore the clinical, pathological, and radiographic features of three rare lung disorders.

CHEST ID: 2059

CTD-ILD, Overview of the Radiologic Patterns, Treatment Options, and Transplant Outcome

Among all categories of interstitial lung disease, connective tissue disease-related interstitial lung disease (CTD-ILD) is a complex undertaking that requires a multidisplinary approach by pulmonary, radiology, pathology, and rheumatology physicians. Controversies in the diagnosis, management and prognosis of the variant categories of CTD will be discussed in this session. Recent observations have indicated special radiologic patterns on HRCT that might indicate a connective tissue disease as the underlying etiology for ILD. Finally, treatment options for early detected, refractory, and progresive fibrotic interstitial lung disease will be discussed, including lung transplant outcomes compared to other categries of ILD.

CHEST ID: 23858

ICU Management of the ILD Patient in Exacerbation: What Sould and What Should Not Be Done

The etiology of acute exacerbations of interstitial lung disease (AE-ILD) is not fully understood. Different risk factors and triggers, such as infection, mechanical stress, and micro-aspiration, has been proposed. Treatment includes high-dose corticosteroid therapy and antibiotics. AE-ILD carries a poor prognosis and is associated with high mortality within 6 to 12 months.

CHEST ID: 24050

Comorbidities in Interstitial Lung Diseases: An Overlooked Burden

Recent advances in therapeutic options, including the advent of antifibrotic therapies beyond IPF and use of immunosuppressive agents in other ILDs, have led to more purposeful management among these patients. However, treatment benefits seen in pharmaceutical trials are not always applicable to the general ILD population where comorbid conditions significantly affect morbidity and mortality. Strategies for the management of comorbidities associated with ILD are potentially beneficial but the evidence is controversial. This session will involve a diverse group of expert providers discussing current evidence in managing comorbidities such as gastroesophageal reflux, pulmonary hypertension, sleep disordered breathing, and sarcopenia.

CHEST ID: 24130

Rare Interstitial Lung Disease Cases: Choose Your Own Adventure

This session will consist of three rare interstitial lung disease cases presented to the audience in steps, requiring them to choose the next step in diagnosisor management. The case will then progress depending on their choices. At the end of each case, a review will take place to outline best practices and pitfalls as well as take-home messages. The cases will be presented as unknowns and, therefore, diagnosis will not be included in thesubtopic titles.

CHEST ID: 24164

Role of Genetics in Pulmonary Fibrosis – Ready for Prime Time?

Pulmonary fibrosis remains a devastating disease with mortality that is often worse than many cancers. There is increasing recognition of the need for clinical practitioners to understand the important role of genetics in pulmonary fibrosis risk, disease progression and the impact on management. In 4 separate lectures, the presenters will discuss genetic risk factors in interstitial lung abnormalities, familial pulmonary fibrosis, implications for lung transplantation, and therapy. The goal is to provide participants with the skillset to improve the management of pulmonary fibrosis and guide personalized therapeutic choices based on current knowledge of genetic risk factors impacting the disease.

CHEST ID: 24326

Cystic Lung Diseases – A Systematic Approach to Evaluation and Diagnosis

Cystic lung disease (CLD) is a group of lung disorder characterized by the presence of multiple cysts, defined as air-filled lucencies bordered by a thin wall. The differential diagnosis is broad ranging, from environmental exposures to rare genetic disorders. This session aims at addressing the mechanism of cyst formation, imaging characteristics, and diagnostic approaches to CLDs. The goal is to provide a practical approach for diagnostic evaluation of CLD, highlighting disorders in which the HRCT findings can be diagnostic and conditions where correlation with clinical history or biopsy is required.

CHEST ID: 24459

What Is Bronchiolitis? A Case-based Discussion for Diagnosis and Management

Bronchiolitis refers to a set of diseases affecting the small airways, which are frustratingly hard to diagnose and manage. Misdiagnosis and treatment delay may result in progressive respiratory decline. Early recognition of culprit drugs, exposures, and systemic disease amenable to immunosuppression are among potential interventions. The objectives of this session are to: 1) Present clinical tools to recognize bronchiolar disorders as the predominant or contributing pathology; 2) Identify the likely etiology through clinicoradiologic correlation; and 3) Appreciate the histopathologic pattern of bronchiolar disorders and the appropriate clinical context to obtain histopathology.

CHEST ID: 24532

Mock Multidisciplinary Discussion in Interstitial Lung Diseases – To Biopsy or Not

A proactive approach to the diagnosis of patients with ILD and early comprehensive medical care is critical to their prognoses. Dynamic interaction between pulmonologists, pulmonary pathologists, and thoracic radiologists improves diagnostic agreement for ILD. While most academic medical centers conduct routine multidisciplinary discussions to aid in decision-making, this expertize may not be readily available in the community setting. This interactive session aims to mock real-world multidisciplinary discussions, providing community pulmonologists a template they can emulate at their own institutions. We will focus on the key question of whether to biopsy or not, given the morbidity/mortality associated with surgical lung biopsy.

CHEST ID: 24645

Could My job Be Killing Me? Chronic Lung Disease Due to Occupational Exposure

Publication of the ATS/ERS statement by Blanc (below), recent reports of exposures causing interstitial lung disease (ILD) in dentists and autoimmune ILD in stone fabricators, and numerous studies delineating the impact of job exposures in sarcoidosis, asthma, and COPD suggest that for adult practitioners, an occupational history should be of the utmost importance. Yet integrating occupational health assessments into practice is difficult due to a lack of training and awareness of the scope of the problem. This session will include occupational lung health experts to deliver practical advice on recognition and management of occupational lung disease.

CHEST ID: 24661

Uncertainty in Cryobiopsy – Case Discussion

Recent CHEST guideline for performing cryobiopsy provided standardized technique recommendations. However, patient selection for cryobiopsy is key when performing this procedure. Using interactive cases, the presenters will illustrate cryobiopsy in instructive cases to review patient selection, complication management, and when to consider cryobiopsy as a modality to use.

CHEST ID: 24709

Challenges of Diagnosing and Treating Lung Cancer in ILD

Management of lung cancers with underlying interstitial lung diseases has unique challenges. During this 60-minute session, divided into 4 separate lectures, we will discuss the incidence and epidemiology of lung cancers in this population, the role of biologics and chemotherapy effects, and radiation therapy and associated complications with underlying ILD. In addition, use of genomic classifier and surgical considerations will be covered. The goal is to review the importance of early diagnosis of cancers and discuss common drugs that can both cause or worsen ILD to help guide safe drug choice and recognition of pulmonary adverse effects of these drugs.

CHEST ID: 24819

Outside the Lungs: Extrapulmonary Complications of Sarcoidosis

Sarcoidosis is a multisystem disorder of unknown etiology that is characterized by deposition of granulomas in various organs. Although lungs and lymph nodes are most commonly involved in sarcoidosis, it can affect other organ systems as well. Even though uncommon, pulmonologists should be cognizant of clinical manifestations of extrapulmonary sarcoidosis. Although unusual, extrapulmonary organ involvement has a considerable impact on symptom burden, quality of life, and prognosis for patients.

CHEST ID: 24838

NetWork Bites: Interstitial and Diffuse Lung Disease

CHEST ID: 7010

NetWork Bites: Disaster Response and Global Health

CHEST ID: 7010

Persistent Air Leak: Management Approaches for a Community Pulmonologist

Persistent air leaks are a therapeutic challenge for pulmonologists and thoracic surgeons. A multidisciplinary approach is key in the management of these challenging cases. Pulmonologists in nontertiary care centers may often come across such situations, where services of thoracic surgeons and interventional pulmonologists may not be readily available. Moreover, within the US, lack of medical insurance limits many bronchoscopic interventions, which are now the more favored approach in these settings, as a result of which resources are limited in many public county hospitals, a situation similar in many developing countries. This session will involve presentation of three to four such cases encountered in a public county hospital; following which a panel of two to three international experts in pleural diseases will be asked to present their views on management of these cases in resource-limited settings and resourceful settings.

CHEST ID: 24062

What’s New in Pleural Disease? Notable Trials and New Information

This session will review common pleural conundrums and highlight recent and ongoing trials that provide guidance to managment. A multidisciplinary team of experts from around the world will discuss practical lessons learned from large randomized trials as well as recent consensus guidelines.

CHEST ID: 24290

ICU Care Transitions: Patient Movement, Provider Flux, and Communication Challenges

Medical errors are a common cause of death, and care transitions have been identified as a major contributor to medical errors. Research in informatics, human factors, and implementation science supports frameworks and practices for reliable transitions (eg, standardization, active bidirectional communication). While this evidence has been translated into practice for lower-risk transitions (eg, ward shift handoffs), an awareness and implementation gap remains for higher-risk ICU transitions. We aim to increase awareness of this gap and its influence on important outcomes, to provide attendees with systematic approaches for planning and communicating around ICU transitions, and to discuss solutions to these problems.

CHEST ID: 24195

Assessment as a Priority in Curriculum Design: Planning Your End Game From the Beginning

When designing medical education curricula, the ultimate educational goals and plans for assessing the curriculum’s effectiveness should be considered from the beginning and inform the entire designing process. This session will discuss methods for planning learner and curriculum assessment in initial curriculum design.

CHEST ID: 24320

Pulmonary Procedural Assessment Tools: A Destination Story

This session will involve insturction on how to use several different assessment tools for commonly performed pulmonary procedures. The audience will watch a brief video of a procedure then be instructed on how to use an assessment tool by the faculty. The audience will work in small groups to share and discuss their evaluations prior to the faculty sharing their application of the assessment tools. We will review the Ontario Bronchoscopy Assessment Tool (OBAT) for conventional bronchoscopy, EBUS-STAT for EBUS TBNA, and iCOMPT for chest tubes. If additional time (beyond 60 minutes) is available then we can expand the program.

CHEST ID: 24345

Beyond “Good Job” and “Keep Reading”: What Effective Feedback Looks Like

Education and feedback is critical during training and throughout our careers. However, time demands, personality and learning style differences, and generational gaps can make the process of giving and receiving feedback difficult. This session will discuss crucial elements to giving and receiving effective feedback, both written and verbal.

CHEST ID: 24394

The “Lost to Follow-up” Epidemic: Impact and Tools You Can Use in Your Practice

“Patient lost to follow-up, that all too familiar cause of treatment plan non-adherence, is a short-hand euphemism for an often multifactorial “”failure to find”” that frequently leads to poor outcomes with substantial emotional and financial impact on patients, clinicians, and health care systems. In this interactive, case-based session, participants will learn the surprising/alarming scale of this problem and walk away with practical guides and tools to identify at-risk patients, communicate with them more effectively, and provide a feasible safety net including, but not limited to, technological solutions.”

CHEST ID: 24586

Legal and Ethical Perils of Social Media Use in Medicine: A Real-world Case-based Session

The use of social media is not without peril for medical professionals. More and more clinicians are using social media professionally for career advancement, networking, and promotion. However, the use of these platforms comes with new ethical and legal challenges. In this case-based session, our panel will discuss the common ethical and legal pitfalls of social media use and share best practices for social media use.

CHEST ID: 24774

How to Get Published: Tips From the Editors

Preparing manuscripts for submission to medical journals is an essential skill in academic medicine. Knowing what to do, and not to do, makes for a more rewarding and productive effort. In this session, editors from a leading pulmonary/critical care journal and a leading general medical journal will discuss what editors look for when evaluating manuscripts, common mistakes made by authors, and tips to avoid them.

CHEST ID: 24787

Look, Listen, See, and Learn: New Technology in Medical Education

Learning styles may vary among trainees and educational programs can benefit from incorporating various teaching models. The use of simulation and hand-on teaching are excellent modalities for kinesthetic learning, but they may require costly equipment and facilities. Advancement in virtual technology may provide similar benefits and can be used for procedural training. Medical infographics and educational videos using social media also provide tidbits of learning on the go. In this session, we will highlight the use of virtual technology, education videos, and social media for education and provide guidance of implementation.

CHEST ID: 24824

Burnedout, MD. Burnedout, RT. Burnedout, NP/PA. Finding Joy in Medicine: Proven Strategies

Burnout is characterized by emotional, mental, and physical exhaustion caused by stress of any kind. Studies have shown that burnout is amongst the worst in medicine, and the subspecialty fields of cardiology, critical care, and cardiothoracic surgery, encompassed by CHEST, are linked to some of the worst burnout rates in medicine. How then do we build resilience into ourselves so we continue to find joy in medicine?

CHEST ID: 24888

NetWork Bites: Clinical Research and Quality Improvement

CHEST ID: 7010

Changing Face of Sickle Cell Disease

Sickle cell disease is a group of inherited red blood cell disorders. People who have sickle cell disease have an abnormal protein in their red blood cells that causes abnormal oxygenation, leading to acute chest syndrome and hypoxic damage to lungs, which can be life threatening. Sickle cell disease can also lead to ischemic heart disease and pulmonary hypertension. With time, there is progressive loss of lung function and increasing thromboembolic risk leading to chronic hypoxemia. It is important to understand disease progression and management of its complications, as with time, it is becoming an adult pulmonary disease.

CHEST ID: 24132

Point-of-care Ultrasonography: Competency, Credentialing, Billing, and Naysayers

Point-of-care ultrasonography (POCUS) is widely used by intensivists and pulmonologists. Across the country, hospitals and hospital systems are being forced to reckon with assessing competency and credentialing clinicians that use POCUS for patient care. Furthermore, many intensivists and pulmonologists have begun to bill for their POCUS examinations, with little guidance available on best practice. This landscape has created a fertile ground for controversy in+D49 all of these areas. This session aims to address these important issues.

CHEST ID: 23958

Benign Lung Masses

Lung masses are frequent. Most of the emphasis has been placed on malignant etiologies. There is a subgroup of benign pulmonary tumors or infection that should be considered in the differential diagnosis when these radiographic abnormalities are noted. Utilizing case-based presentations and panel discussion, the speakers will review clinical presentation, radiographic findings, and the histopathology presentation of nonmalignant lung diseases presenting as pulmonary masses.

CHEST ID: 24442

POCUS Ultrasound in the Clinic

POCUS has become standard of care for the ICU but has had limited use in pulmonary clinics, where spirometry and 6-minute walks rule the diagnostic procedures. Some pulmonary clinics have found it profitable to purchase an ultrasound for use with thoracentesis, but this is not widespread due to reimbursement. In the work-up for dyspnea, a few minutes with the ultrasound and some focused knowledge and skill in lung, pleural, and cardiac ultrasound can quickly guide further work-up and treatment for pulmonary clinic patients. This panel will illustrate ways to add this skill to a pulmonary practice.

CHEST ID: 24793

NetWork Bites: Thoracic Oncology

CHEST ID: 7010

Pulmonary Toxicities of Immune Checkpoint Inhibitors (ICI)

“As the role of immunotherapy in cancer has expanded, chest physicians must detect and manage the systemic and pulmonary complications of its use. Informed decisions about diagnostic evaluation and treatment requires recognizing the common and uncommon clinical and radiographic presentations, as well as predisposing and exacerbating conditions. The session will provide an update for immunotherapy in cancer, pulmonary toxicities related to these agents, and patient characteristics that increase risk. “

CHEST ID: 2061

American Association for Bronchology and Interventional Pulmonology: Multidisciplinary Approach to Trapped Lung Syndrome. When Should We Intervene?

What is the meaning of trapped lung and is there anything we can do as physicians to prevents its development?

CHEST ID: 2154

American Association for Bronchology and Interventional Pulmonology: Approach to Peripheral Lung Lesions. What Every Practicing Pulmonologist Needs to Know Now!

“With rapid technological developments for the approach to lung nodules, what does every pulmonologist need to know when evaluation this common finding”

CHEST ID: 2156

American Association for Bronchology and Interventional Pulmonology: Non-surgical Treatment of Stage I Lung Cancer. What Works?

“The standard of care for stage I non-small cell lung cancer (NSCLC) is lobectomy with lymph node dissection. Radiation is standard treatment for patients who cannot tolerate surgery. But are there any other options, such as ablative therapies?”

CHEST ID: 2157

Endobronchial Ultrasound. Understand TNM-8 Nodal Staging and Improve Your Yield?

Endobronchial ultrasound (EBUS) has changed the diagnosis of malignant and nonmalignant mediastinal diseases. There are, however, some essential knowledge, technical, and specimen-handling skills that are essential to correctly diagnose and stage lung cancer and other mediastinal disorders. Important changes have been made in TNM-8 nodal staging that have implications on cancer management. In addition, EBUS literature is rapidly expanding and highlights of important studies need to be disseminated.

CHEST ID: 24357

Eligibility, Dissemination, and Access to Lung Cancer Screening: Challenges and Opportunities

Annual lung cancer screening (LCS) is one of the few public health interventions proven to reduce lung cancer mortality, yet utilization and implementation remain overburdened by barriers, including how best to select high-risk individuals and how to improve access to high-quality screening. There is concern that disparities in implementation of and access to LCS will further widen the disparity gaps that occur in lung cancer. Three separate lectures will review current disparities in LCS eligibility and access and explore strategies to improve selection and access. The goal is to provide participants with the knowledge to promote equitable LCS.

CHEST ID: 24363

Lung Cancer in Interstitial Lung Disease: An Emerging Dilemma

There is known association between interstitial lung disease (ILD) and lung cancer (LC), of which the combination is known to have increased morbity and mortality. While there are described radiographic presentations, clearly identifying a malignant lesion can be challening in diffuse parenchymal lung disease. There are risks with diagnostic modalites, which include pneumothorax and acute exacerbation of ILD. However, paucity of resources is available to guide clinicians. Our session aims to identify the shared risk factors and pathophysiology, understand the common radiographic presentations, and offer recommendations for diagnostic work-up in patients with ILD and suspected LC.

CHEST ID: 24407

Addressing an Invisible Epidemic: Lung Cancer in Women

Lung cancer in women is a modern epidemic and a major global health crisis. Cigarette smoking remains the most important risk factor but lung cancer in nonsmokers is more common among women and data points to sex differences in the biology of lung cancer. The benefits of lung cancer screening were significantly greater in women on the NELSON trial. However, current screening criteria identify fewer women than men who develop lung cancer. Continued attention must be paid to sex differences in lung cancer risk, screening criteria, and treatment outcomes, and the impact of this disease on women’s health issues.

CHEST ID: 24449

Effect of Frailty on the Diagnosis and Management of Lung Cancer in Older Patients

The majority of patients with lung cancer are diagnosed after 65 years of age, and while several treatment options exist for older patients, they can be associated with significant morbidity, mortality, and adverse effects on quality of life – due in part to frailty. Frailty is a syndrome of physiological decline in later life, characterized by significant vulnerability to adverse health outcomes including procedural complications, falls, disability, and death. Decision making regarding screening and treatment in older patients is difficult due to their underrepresentation in clinical trials and a lack of evidence on risk stratification for patients can be considered frail.

CHEST ID: 24528

Controversies in Indwelling Tunneled Pleural Catheter Management

“The management of recurrent pleural effusions remains a challenging issue for clinicians. Advances in management have led to increased use of indwelling tunneled pleural catheters (IPC) due to their effectiveness and ease of outpatient placement. However, with the increase in IPC placement, there have also been increasing reports of complications, including infections. Currently there is minimal guidance in IPC-related management issues after placement. This session will involve pro/con discussions around two key areas of controversy: 1) IPC drainage schedule recommendations and 2) Management of IPC-related infections.”

CHEST ID: 24550

Rapid Fire: Mythbusting Early Stage Lung Cancer

This session will focus on various aspects of early-stage lung cancer and will explore, and in some instances, dispel, certain myths as they relate to the evaluation, diagnosis, and management of patients with this disease. The topics are meant to be provocative and thought provoking, and reflect contemporary aspects in the areas of risk stratrification, lung cancer screening, biomarker development, diagnostic techniques, and treatment. Topics will be presented in a rapid-fire format, in which speakers will have no more than 10 minutes to present evidence where it exists, and balanced discussion where it does not.

CHEST ID: 24574

Oligometastatic Disease: Changing the Long-Term Management of Metastatic Lung Cancer

Oligometastatic non-small cell lung cancer (NSCLC) represents a distinct subset of NSCLC patients with limited metastases who are living long-term after definitive treatment to all sites of active disease. One of the current limitations of aggressive treatment of oligometastatic NSCLC is the inability to accurately identify these patients before therapy. Three separate lectures will review clinical criteria, local ablative therapies, and emerging systemic therapies in oligometastatic NSCLC. Cases will be used to highlight multidisciplinary approaches to the diagnosis and treatment of oligometastatic disease.

CHEST ID: 24596

ROSE It Yourself

FDG avid mediastinal adenopathy whether related or unrelated to a primary lung lesion, is not an uncommon radiographic finding. This case-based presentation involving an expert interventional pulmonologist, radiologist, pathologist and infectious disease physician, will guide the practitioner through various clinical paths and outcomes in patients with mediastinal disease. The demonstration of optimal endoscopic techniques as well as the utility of rapid onsite cytopathologist evaluation (ROSE) will be discussed.

CHEST ID: 24352

Asthma and Women: Through the Lifespan

One in 13 people in the United States have asthma, and prevalence of asthma in women 18 to 44 years of age has increased in the last 15 years. Sex-related differences in asthma prevalence are well established and change through the reproductive phases of life. By puberty, prevalence of asthma starts to change and it is more frequent in women during adulthood. Fluctuations of hormones during puberty, menstruation, pregnancy, and menopause alter asthma symptoms and severity. Understanding these differences is key to suspecting, diagnosing, and managing asthma through various stages of a woman’s life.

CHEST ID: 23929

Advances in Bronchoscopic Treatment of Emphysema

Emphysema is a debilitating disease, with increasing morbidity and mortality worldwide. The main goal of therapy is symptomatic relief and improvement of quality of life through different medical treatment. However, such therapies cannot reverse or significantly reduce hyperinflation, leaving patients with poor quality of life. In a selected subgroup of patients with predominant emphysema and hyperinflation, bronchial valve therapy represents a further treatment option, recently approved by the FDA. The purpose is to provide a comprehensive summary of currently available clinical trials, discuss common complications and their management, as well as evaluation of proper patient selection in clinical practice.

CHEST ID: 24237

The Significance and Management of Excessive Dynamic Airway Collapse: A Pro/Con Debate

Excessive dynamic airway collapse (EDAC) is often noted during bronchoscopy, but what is it, what percent of collapse clinically matters, and should you treat it? This session will focus on the controversies regarding the diagnosis, significance, and potential management of EDAC, including tracheoplasty. The audience response system will be used to allow the audience to participate within the debate.

CHEST ID: 24447

Approach to Pulmonary Disease in the Geriatric Patient

Chronic lung diseases (eg, chronic obstructive pulmonary disease (COPD), noncystic fibrosis bronchiectasis, and interstitial lung disease (ILD)) disproportionately affect older adults. Because the US health system siloes disease management by organ system and subspecialty, pulmonary interprofessional teams lack the training to assess and manage the complexity of care for these older patients. This session will explore the natural history of lung aging, discuss management of geriatric patients with COPD, ILD, and bronchiectasis, and focus on management of geriatric syndromes (eg, function and polypharmacy), symptom management, and advance care planning.

CHEST ID: 24715

Hidden Exposure: How to Uncover the Cause

This session aims to teach participants about mechanisms to understand if environmental and occupational exposures are the cause of lung disease. This is designed to be a interdisciplinary session that will include occupational specialists to explore the various aspects of a patient’s life and to find where an exposure may be lurking. Speakers will explore the relative strengths and weaknesses of clinical, work, and home assessments.

CHEST ID: 24839

NetWork Bites: Occupational and Environmental Health

CHEST ID: 7010

NetWork Bites: Women’s Lung Health

CHEST ID: 7010

NetWork Bites: Palliative and End-of-Life Care

CHEST ID: 7010

Ethical Challenges in the Management of Patients on Extracorporeal Membrane Oxygenation

The increasing incidence and innovative utilization of extracorporeal membrane oxygenation (ECMO) has challenged the current paradigms regarding the extraordinary measures available to support, or even replace, basic biologic functions that sustain human life. Paradoxically, despite the ability of ECMO to act as a life-prolonging intervention while awaiting organ recovery and/or additional curative medical therapies, it potentially creates moral dilemmas in other cases. This session will apply a shared-decision making model to explore the clinical reasoning process and ethical considerations for the initiation, continuation, and cessation of ECMO in two challenging patient cases.

CHEST ID: 24835

What’s New in Pediatric Asthma

The approach to severe problematic asthma in children requires a coordinated pharmacological and, more importantly, nonpharmacological paradigm to care. This session will review the medical management of problematic asthma in children, and examine how best to care in an interdisciplinary manner and create a clinic to manage these children. Recent recommendations from guidelines, including GINA 2019, and how they pertain to children will also be reviewed.

CHEST ID: 2062

Wheezing in Infancy and Risk for Asthma and COPD in Adults

Recurrent wheezing is common in young children and is usually associated with viral illnesses. Children wheeze because of prematurity, allergies, structural airway problems, GERD, and exposure to smoking, etc. Acute wheezing carries morbidity. Many children stop wheezing by the time they are 4 to 5 years old or in their teens. It is not clear who is at risk of developing childhood and adult asthma. Some may be at risk of airway remodeling and development in COPD in adults. This session will address work-up and immune dysregulations, and help in diagnosing those at risk for asthma and COPD.

CHEST ID: 24092

NetWork Bites: Pediatric Chest Medicine

CHEST ID: 7010

NetWork Bites: Interprofessional Team

CHEST ID: 7010

NetWork Bites: Practice Operations

CHEST ID: 7010

NetWork Bites: Interventional Chest/Diagnostic Procedures

CHEST ID: 7010

Central Airway Obstruction and Foreign Bodies: Principles of Diagnosis and Management

Central airway obstruction is a debilitating and life threatening condition. It can be caused by a variety of benign and malignant disorders. Detailed understanding of underlying pathophysiology and therapeutic bronchoscopic skills are essential in managing these complicated patients. Foreign body aspiration can be challenging for the pulmonologist and different approaches and techniques will be discussed.

CHEST ID: 24353

Anesthetic Considerations in Bronchoscopy – View From the Pulmonologist’s Standpoint

Pulmonologists seem divided about the optimum anesthetic modality for bronchoscopic procedures. This is largely a result of practice preference and available infrastructure at their institutions. Practice patterns are influenced by evidence behind use of a specific anesthetic modality or pressure stemming from an institution’s understanding of resource utilization. The session will inform the audience with evidence-based information needed to optimize their practice or make a case for advanced anesthetic support. Anesthetic considerations for therapeutic bronchoscopy will also be discussed.

CHEST ID: 24417

Bronchoscopic Lung Volume Reduction: Maximizing the Silver Lining and Minimizing the Storm Clouds

Bronchoscopic lung volume reduction (BLVR) for the treatment of symptomatic maximally treated chronic obstructive lung disease provides an emerging treatment for patients who meet criteria. Studies have reported that patients treated with BLVR experienced improvement in FEV1, FVC, 6-minute walk distance, and symptomatic measures. These impressive improvements do not come without risk, with serious post-procedural adverse event rates ranging from 21% to 47.7%. This interactive session will present the data for the procedure, patient selection criteria, and managment of complications in an interactive, case-based format aimed at improving patient selection and incorporation of BLVR into the practicing clinician’s treatment paradigm.

CHEST ID: 24633

Targeting the Periphery of the Lung: The Final Frontier

New technologies and approaches to peripheral lung nodule diagnostics are being introduced at an increasing rate. In order to assist attendees’ understanding of the true definition of diagnostic yield and its importance in lung nodule biopsy in the periphery of the lung, this session will provide an evidence-based review and assessment of the current literature and controversies surronding diagnostic yield in bronchoscopy. Case-based examples highlighting specific advances in peripheral bronchoscopy will be disussed. Active audience participation will be encouraged- with ample question- and answer-focused material.

CHEST ID: 24726

Pulmonary Manifestations of Hematologic Malignancies: A Case-Based Overview

Pulmonary disease can occur across the entire disease spectrum of hematologic malignancies, presenting as a lung mass, a malignant pleural effusion, lymphadenopathy, or superior vena cava syndrome. The diagnosis of these malignancies can be challenging, and hematologic aberrancies and immunosuppression may complicate management. In this session, three different case-based scenarios will highlight pulmonary manifestations of hematologic malignancies.

CHEST ID: 24427

NetWork Bites: Pulmonary Physiology Function and Rehabilitation

CHEST ID: 7010

PFT Cases: Perplex the Professor

Pulmonary function testing (PFT) is an integral part of most pulmonary medicine practices. Many studies have documented that practitioners do not reliably interpret PFTs in accordance with current guidelines. This session will aim to demonstrate correct interpretation of interesting and challenging PFT cases, emphasizing compliance with current PFT guidelines. It will consist of four pulmonary fellows presenting two or three cases, exhibiting a variety of challenging PFT cases to a panel of three experts in PFT interpretation

CHEST ID: 2056

Field Tests – Assessing Activity Limitation

“Activity limitation is a cardinal finding in medicine, and a frequent symptom of individuals assessed by clinicians. Objective evaluation of activity limitation assists both with its evaluation and in determining etiology. While several modalities are available for use, there is genuine uncertainty regarding the best test for different purposes, as well as regarding practical conduct and interpretation in various clinical settings. This session will review objective reasons for assessing activity limitation, and discuss different methods for varying purposes. Using a case-study approach, practical guidance for the selection, conduct, and interpretation of activity field testing in clinical practice will be provided. “

CHEST ID: 2057

Big and Breathless: Obesity and Pulmonary Disorders

One in three Americans (>100 million) are obese. Adult and childhood obesity rates have increased by 70% and 85%, respectively, over the past three decades. Obesity-related illnesses cost $190 billion annually (21% of US medical spending). Obesity affects the respiratory system in myriad ways — respiratory mechanics, pulmonary function, oxygenation, ventilation, symptoms, etc. Obesity can adversely impact asthma, COPD, OSA, obesity hypoventilation syndrome, etc, with improvements after weight loss. There is under-recognition of the effects of obesity on various pulmonary disorders. This session would enhance awareness and bridge knowledge gaps regarding the impact of obesity on common pulmonary disorders.

CHEST ID: 23869

Challenges of Air Travel in Patients With Pulmonary Disease

Approximately 4.23 billion passengers worldwide ( >1 billion US) travelled by air in 2018.The hypoxic and hypobaric aircraft cabin can lead to exacerbation of chronic cardiopulmonary disorders. Respiratory symptoms accounted for 12% of in-air emergencies, are the third most-frequent cause for aircraft diversion, and are an increased risk of hospitalization post-flight. There’s also increased risk of venous thromboembolism and potential communicable diseases transmission due to relative immobility and proximity of passengers, respectively. This session familiarizes the audience with flight physiology, preflight risk stratification of patients, and disease-specific air travel recommendations. Medical resources available in-flight and practical considerations for managing in-flight medical emergencies are also discussed.

CHEST ID: 23886

Cardiopulmonary Exercise Testing – Practical Case-based Pearls

Cardiopulmonary exercise testing (CPET) is an essential diagnostic investigation for unexplained dyspnea, activity limitation, perioperative evaluation, return to exercise training planning, and disability assessment. This session will combine outstanding expert faculty and clinical cases, utilizing a practical and interactive case-based format with active audience participation. Clinical case discussions will be coupled with the medical literature and combined with practical take-home clinical pearls for participants.

CHEST ID: 24159

Pulmonary Rehab: Where We’re At and Where We’re Going

This session will focus on recent developments in pulmonary rehabilitation (PR), centered on improving outcomes not only during active participation in PR, but maintenance of those gains following PR completion. Further, the referral rate for PR is extremely low and many patients with COPD may be unaware of its existence despite having a high symptom burden. Unfortunately, this problem is worsened by PR program availability and proximity issues – and this session also will include a discussion on improving the availability and accessibility of this extremely important treatment modality.

CHEST ID: 24540

Controversies in the Management of Intermediate and High-Risk Pulmonary Embolism

Risk stratification and treatment options for patients with intermediate-high (submassive) and high (massive) pulmonary embolism has continued to evolve. Recently published guidelines stress the importance of severity assessment and risk-adjusted approaches to management. One area of particular interest in recent years is the utilization of pulmonary embolism response teams (PERT) to guide the managment of these complex patients. Another evolving area of controversy is the optimal use of mechanical circulatory support in acute PE-associated shock or cardiac arrest. This session will include two pro/con debates surrounding these issues.

CHEST ID: 23804

Too Much of a Good Thing or Not Enough? Treating Scleroderma With ILD and PH: A Pro-Con Debate

Current guidelines advise treatment for pulmonary arterial hypertension (PAH) but not interstitial lung disease- (ILD-) associated pulmonary hypertension. Patients with scleroderma often present with both, and while targeted therapy may improve PAH, it may be harmful in ILD, and the optimal treatment strategy is unclear. Using a Pro-Con debate format, this session fulfills the needs of cardiac and pulmonary practitioners in reviewing the management of patients with mixed PAH and ILD. At the conclusion of this session, participants will appreciate the risks and benefits in treating these patients, and be able to apply this knowledge to their own clinical practice.

CHEST ID: 24003

Updates in Management of Chronic Thromboembolic Pulmonary Hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is the most feared long-term complication of pulmonary embolism. Treatment options available for these patients include pulmonary thromboendarterectomy (PTE), balloon pulmonary angioplasty (BPA), and treatment with pulmonary vasodilators. Appropriate selection of treatment requires comprehensive and multidisciplinary patient assessment. Additionally, despite data that patients do better with expert referral, such referral is often delayed. This session will utilize cases and audience response to highlight available treatments with a focus on recent advances in treatment, including minimally invasive PTE as well as the role for combining multiple therapies.

CHEST ID: 24364

Is My Patient’s Pulmonary Hypertension Left or Right? The Probe and the Catheter Come to Your Rescue

Group 2 pulmonary hypertension (PH) is the most common type of PH. Also known as PH due to left heart disease, it corresponds to elevation in pulmonary pressures through a retrograde pressure increase from left heart chambers and valve disease. Pulmonary manifestations of left heart disease accounts for a significant number of patients being evaluated for PH and dyspnea or unknown origin. Comprehensive echocardiographic and right heart catheterization assessment is frequently needed to adequately excude (or confirm) the presence of left heart-associated PH. Keypoints will be provided to get the most value from those two diagnostic tests.

CHEST ID: 24420

The Crashing Pulmonary Arterial Hypertension Patient: An Intensivist’s Nightmare

Intensive care unit admission in a patient with pulmonary arterial hypertension (PAH) carries significantly increased morbidity and mortality. The need for ionotropes, mechanical ventilation, dialysis, and cardiopulmonary resuscitation are associated with increased mortality. Current literature lacks prospective data on management of these critically ill patients, and management is based on understanding the pathophysiology of disease and expert opinion. This case-based session will include challenging cases of critically ill PAH patients. The presentations will focus on current management strategies, advanced therapies, mechanical circulatory support for right ventricular failure in PAH patients, and urgent transplantation as rescue therapy.

CHEST ID: 24425

NetWork Bites: Pulmonary Vascular Disease

CHEST ID: 7010

Compassionate Extubation: Many Parts to One Common Goal

Compassionate extubation is a common and complex interdisciplinary process, which allows a patient to be relieved of life-sustaining therapies and transition peacefully. Ethics, symptom management, counseling, and self-care are all important components of this process. In this session, an interprofessional panel, including physicians, a respiratory therapist, and a chaplain, will detail some of the considerations and challenges surrounding compassionate extubation. The multidisciplinary perspective will be highlighted, as well as ways to recognize, prevent, and treat compassion fatigue and burnout in yourself and your colleagues.

CHEST ID: 23968

Improving Outcomes in Neuromuscular Respiratory Failure: It Takes More Than Just Guidelines

This case-based session begins with a case of an adult neuromuscular respiratory failure patient. Expert faculty will take the audience through pathophysiology, and evidenced-based and expert opinion management decisions, specifically in regards to noninvasive ventilation and mechanical airway clearance. The role of the overnight sleep study will be discussed, as there is a large overlap between the neuromuscular pulmonologist and the sleep pulmonologist in regards to evaluation and management decisions. Latest clinical trials focused on the respiratory management of neuromuscular respiratory failure will be reviewed, including the 2019 Canadian Thoracic Society guidelines.

CHEST ID: 24106

Bridging the Gap: Pediatric to Adult Transition for Home Mechanical Ventilation

Medical advancements are allowing children with chronic respiratory failure to live into adulthood. This growing population necessitates adult providers with expertise in home mechanical ventilation who can address the unique needs of this vulnerable patient population. Most academic medical centers have no formal transition process for patients on home mechanical ventilators. Four panel experts will discuss the various components of a formal transition program, including barriers, timing, patient/family preparation, multidiciplinary approach, psychosocial care, and integration of young adults into adult care.

CHEST ID: 24559

The Nuts and Bolts of Home Mechanical Ventilation Transition: Hospital to Home

Technology for home-based mechanical ventilation is rapidly evolving, expanding the capabilities of caring for adults with chronic respiratory failure at home. Care for chronic respiratory failure in the home is complex, requiring knowledge on recognizing appropriate candidates for home ventilation, understanding insurance qualifying criteria for home ventilators, identifying an appropriate durable medical equipment company, and familiarity with common home ventilator capabilities and settings. This interactive session will include a multicenter, international perspective on various considerations and knowledge base required to safely transition a patient with chronic respiratory failure from the hospital to the home.

CHEST ID: 24632

NetWork Bites: Respiratory Care

CHEST ID: 7010

“All That Wheezes Is Not Asthma”: A Focus on Structural Asthma Mimickers

General pulmonologists often encouter patients referred for evaluation of difficult-to-control asthma due to persistent wheezing refractory to bronchodilators. The focus of this session is to discuss entities that can mimick asthma due to persistent wheezing, with an emphasis on when to suspect an alternate diagnosis and presenting cases to discuss frequently encountered clincal scenarios (inducible laringeal obstruction, tracheobronchomalacia, and benign central airway obstruction).

CHEST ID: 23883

NetWork Bites: Sleep Medicine

CHEST ID: 7010

ASV, AVAPS, and CPAP Titrations: Practical Approaches to Asynchronies and Difficult Titrations

In-laboratory PAP titration studies aim to identify appropriate positive airway pressure (PAP) device settings to provide optimal patient benefit. Despite the use of guidelines to assist in titrations, unexpected physiologic responses, such as tachypnea or central apneas, may occur. Through clinical cases, the presenters will each address difficult PAP titrations, including treatment-emergent central sleep apnea, adaptive servo-ventilation, and average volume-assured pressure support. The goal is to provide participants with practical approaches to troubleshoot difficult titrations and asynchronies.

CHEST ID: 23906

Understanding the Intricacies of OSA Overlap Syndromes: A Case-based Approach

This evidence-based session will discuss the care of patients who have other pulmonary comorbid conditions in addition to obstructive sleep apnea syndrome. Case-based discussion will focus on key clinical findings, differential diagnosis, and potential pitfalls. Topics will range on a broad range of chest diseases, including obstructive lung disesase, pulmonary fibrosis, and pulmonary hypertension. Topics will be relevant to trainees, generalists, and specialists alike. At the conclusion of this course, learners will have increased knowledge about OSA overlap syndrome and will be able to apply this knowledge to respective practices.

CHEST ID: 23978

Sleep Disorders in Women Across the Lifespan

Sleep disturbances are highly prevalent in women across the lifespan. This session will explore the ways in which women are uniquely impacted by sleep symptoms and disorders during pregnancy, during menopause, and with respect to sleep-disordered breathing. The presence of sleep apnea is associated with several adverse maternal outcomes, including gestation hypertension, making prompt diagnosis and treatment critical. During the menopausal transition, women commonly experience symptoms of insomnia, hot flashes, and nocturia, with significant impact on quality of life. Sleep apnea may be underrecognized in women, whose clinical presentation may differ from that of men.

CHEST ID: 23994

Sleep in Older Adults: What’s Normal, What’s Not, and Why Does It Matter?

The aging process is associated with changes in sleep quality, sleep architecture, circadian rhythms, and sleep disorders, including insomnia. This session will highlight three important topics related to sleep medicine in the elderly, including whether and when to treat sleep-disordered breathing, management of insomnia, and emerging research linking sleep disturbance to development of neurocognitive dysfunction and dementia.

CHEST ID: 23995

Sleep-Disordered Breathing in the Hospital: From Inpatient Sleep Testing to Perioperative Management

The presence of sleep-disordered breathing has been shown to impact outcomes among hospitalized patients. This session will highlight key elements to successful evaluation and management of SDB in the hospital. Topics covered will include role of inpatient sleep testing, choosing the appropriate PAP device in the perioperative setting, and strategies for managing obesity hypoventilation syndrome from admission to the outpatient setting.

CHEST ID: 24013

Recognizing and Reducing the Impact of Sleep Apnea After Acute Stroke

Obstructive sleep apnea (OSA) is an independent risk factor for ischemic stroke. New data in the past year has shown that use of CPAP in the acute stroke setting can improve short-term and long-term neurologic outcomes. Innovative strategies are therefore now being proposed to incorporate this potentially practice-altering finding. The aim of this session is to discuss the why, how, and when of diagnosing and treating OSA after acute ischemic stroke.

CHEST ID: 24048

Management of Sleep Issues in Special Populations

Patients with autism (with and without intellectual disability), patients with Down syndrome, and elderly patients with dementia each have unique sleep problems. about which providers should be familiar. Management can be more complex in the setting of significant cognitive or neurologic impairment. Care for patients should apply a deliberate approach, considering recommended diagnostic testing and treatment plans in order to meet their specific needs. As new research continues, providers need to remain up to date with new and emerging treatment options. This session will address high-yield topics in the care of sleep issues in these patient populations.

CHEST ID: 24055

Improving Sleep Quality for Hospitalized Patients

This session is on sleep quality for in-patients, looking at three settings: 1) gen-med floor, 2) ICU, and 3) LTAC. Dr. Arura is a hospitalist who published the ‘SIESTA’ study, which improved sleep in gen-med in-patients. Dr. Kamdar is an intestivist who can review his data on the role of sleep quality in reducing delerium. Lastly, Dr. Laghi is a sleep medicine physician who can present data from an LTACH on sound masking to improve sleep. At the end of each talk, the lecturer will review real-wolrd strategies to improve sleep quality for in-patients.

CHEST ID: 24131

Sleep for the Pulmonary Board (Part 1): Acing the Sleep Respiratory-related Questions

The proposed session will be a review of several high-yield sleep-related subjects for the pulmonary board exam. The content areas covered in sleep-related breathing disorders will include normal sleep physiology, obstructive sleep apnea, central sleep apnea, and obesity hypoventilation syndrome. The format will be a board-type, case-based approach with an interactive question-and-answer component (ARS).

CHEST ID: 24141

Sleep and Substances: From Caffeine to Marijuana

Caffeine, alcohol, melatonin, and OTC preparations containing diphenhydramine are some commonly consumed preparations that patients use to treat their sleep disturbances. The newest legally available agent is marijuana. This session will be an evidence-based discussion on the effect of these agents on sleep and pitfalls with their use. We will also discuss the effect of opioids on sleep and sleep disorders in light of the ongoing opioid epidemic. As providers, we are likely to see some of these patients in our clinics who may not disclose their drug use.

CHEST ID: 24197

Sleep for the Pulmonary Board (Part 2): Nonrespiratory Sleep Board-like Questions

The proposed session will be a review of several high-yield sleep related subjects for the pulmonary board exam. The content areas covered in non-sleep related breathing disorders will include circadian rhythm disorders, restless leg syndrome, insomnia and hypersomnia. The format will be a board type case-based approach with an interactive, question-and-answer component (ARS).

CHEST ID: 24313

Sleep Pearls for the Pulmonary Provider

Patients with chronic pulmonary disease often have comorbid sleep disorders or nocturnal hypoventilation. The goal of this session is to help general pulmonary providers successfully screen for and manage sleep disorders. First, we will discuss indications for sleep testing in patients with asthma, COPD, pulmonary hypertension, and ILD. Next, we will provide an evidence-based update on strategies for improving CPAP adherence. Finally, the role of noninvasive ventilation for patients with COPD will be explored, including practical strategies for+D140 succesful approval of devices in this population.

CHEST ID: 24473

Patient Voices in Sleep Medicine

In this unique session, three patients will share their experiences with sleep disorders. The patients will include: 1) A patient with narcolepsy who is a member of the advocacy group Rising Voices of Narcolepsy; 2) A patient with a circadian disorder identified through the Center for Circadian and Sleep Medicine Northwestern’s Feinberg School of Medicine; and 3) A patient with severe restless legs syndrome recommended by the Restless Legs Foundation. After each patient shares his/her story, a summary slide will highlight key points about each sleep disorder. There will be time for the audience to ask questions of each patient.

CHEST ID: 24526

Perioperative Management: OSA, COPD, Neuromuscular Disease and Pregnancy

With the ever-increasing medical complexity of patients, there are evolving risks associated with surgical procedures. This is is especially notable in patients with OSA, COPD, and neuromuscular diseases. These comorbidities add increased risks and complications. Proper knowledge of the risks and treatment options in the perioperative period is especially important. In addition to surgical procedures, there are increased needs associated in people living with neuromuscular disease and pregnancy. This session will address pre, peri and post operative evaluation and management strategies.

CHEST ID: 24558

My Pregnant Patient Has a Sleep Disorder

Sleep complaints are frequent during pregnancy. Specifically, there is an increased prevalence and incidence of RLS, OSA, and insomnia, and data suggests that these disorders may be associated with adverse maternal and fetal outcomes. Concerns over medication safety in pregnancy as well as lack of clear guidelines means that clinicians are faced with challenges in the diagnosis and management of these disorders in pregnancy. Using an audience response system, this session will address key concepts in the diagnosis, outcomes, and management of RLS, OSA, and insomnia in pregnancy by reviewing the current literature and data.

CHEST ID: 24647

Night Time Is the Right Time to Study Your Patient’s Oximetry and PAP Data! Adults and Pediatric.

Nocturnal oximetry and PAP downloards are not used as often as they could be to help optimize patient care. For patients with underlying lung disease such as COPD, ILD, etc, exercise oximetry is often done in the office but nocturnal oximetry is rarely utilized. People with normal lung function have reduced FRC and TV during sleep, so for those with underlying lung disease, the hypoventilation can and often is more significant. For patients with known sleep-disordered breathing, PAP downloards can be very useful to identify problems and how best to optimize treatment.

CHEST ID: 24673

Sleep Medicine for Commercial Trucking, Railway, and Aviation: Updates for the Busy Clinician

Over 20% of motor vehicle accidents are fatigue related (up to 1,000 deaths per year). Legal and regulatory ramifications for accidents involving sleep-impaired operators are evolving with growing visibility as a public safety crisis. Unfortunately, resources to effectively manage sleep complaints and diagnosed conditions are scarce, and many patients face long wait times, during which impaired driving due to insufficient sleep or an untreated sleep disorder is unavoidable. The majority of clinicians who evaluate and manage this population lack a basic understanding of rules and regulations governing commercial transportation operators and potential countermeasures.

CHEST ID: 24794

Sleep M&M Cases – Wild Nights, Misadventure, and Educational Opportunities

The Sleep laboratory at night can be an underappreciated source of consternation. Sleep fellow trainees come from diverse specialty backgrounds and experience handling nighttime emergencies. During laboratory-based polysomnography, patients are monitored by technicians (not providers) with little if any training or experience in identifying and managing medical emergencies. This scenario is very different from a hospital ward with on-site providers (nursing, physicians). Fortunately, emergency events, such as cardiac arrest and generalized seizure, are exceedingly rare. However, other events, such as cardiac telemetry abnormalities, adverse medication reactions, and disorderly conduct, may lead to emergencies that require rapid intervention.

CHEST ID: 24810

E-cigarettes, Marijuana, and Hookah

“Use of e-cigarettes, marijuana, and hookah have markedly increased in popularity throughout the world. This session will discuss the impact of these recreational activities on lung health and share clinical pearls on how to discuss these issues. “

CHEST ID: 2060

The Vaping Epidemic: From Epidemiology to Biology and Policy

Electronic nicotine delivery system use is increasing. Recent estimates of vaping initiation among youth in the US have been called an epidemic with an increase of 10% among 12th graders in 1 year. Increased use has been identified specifically among Hispanic/Latino youth at alarming rates, much higher than non-Hispanic youth. The long-term health outcomes and biological impact of vape exposure are not known. In this session, we will discuss: 1) vaping epidemiology, 2) lung injury, 3) impact on respiratory outcomes, 4) changes in nasal epithelial gene expression, and 5) how this knowledge can inform tobacco policy.

CHEST ID: 24261

NetWork Bites: Clinical Pulmonary Medicine

CHEST ID: 7010

NetWork Bites: Transplant

CHEST ID: 7010

GI Challenges in Transplantation

Upper gastrointestinal disorders are highly prevalent in patients with end-stage lung disease. These conditions can contribute significantly to transplant-related complications. The diagnostic work-up and management of upper gastrointestinal disorders in lung transplant candidates and recipients is challenging and not well standardized. In three separate lectures, the presenters will discuss the different diagnostic tools to evaluate upper gastrointestinal disorders, the association of upper gastrointestinal disorders with transplant-related complications, and their impact on transplant candidacy and strategies for their management.

CHEST ID: 24303

Pleural Complications in Lung Transplant Recipients: Outside the Box!

Presence of preexisting pleural disease is an important consideration for lung transplantation. Additionally, pleural complications are common post lung transplantation due to invasion of the pleural sac and as a results of systemic manifestation of immunosuppression, malignancy, and rejection.

CHEST ID: 24739

Lung Transplantation Referral 101: What You Need for the Boards and the Wards

Lung transplantation maybe the only option for patients with endstage lung disease. This 60-minute session consists of case-based discussions that explore fundmentals and nuisances in when to refer for lung transplantation for patients who suffer from end-stage IPF, cystic fibrosis, and COPD. This session will review current guidelines and guidance papers on who and when to refer, and absolute and relative contraindications to transplantation for these disease states.

CHEST ID: 24849

Immunosuppressed and in The ICU : What Am I to Do?

This 60-minute session highlights the Intensive Care unit needs and care in three organ transplantation populations: liver, lung, and bone marrow transplants. Managing these patients requires some knowledge related to the underlying disease, related treatments (patterns of toxicity, alternative regimen), specific emergencies (ie, tumour lysis syndrome, cytokine releasing syndrome, or acute humoral rejection), or specific clinical vignettes (febrile neutropenia). This session will address some of the specifics of each of these issues in three different transplant popluations admitted to the ICU. In addition, this session will address which patients will not benefit from ICU care.

CHEST ID: 24871