Description:

Based on the seminal observations of Fletcher and Peto, modification of the accelerated decline in FEV1was considered the holy grail in initial clinical trials in COPD. Based on the concept of offering anti-inflammatory therapy, exacerbations and mortality were introduced as outcomes in large intervention studies. These studies have contributed to a tunnel perspective on COPD and a one size fits all approach to a complex heterogeneous syndrome.

Learning Objectives:

•A one size fits all approach is killing for profound understanding of underlying mechanisms of a disease condition.

•A personalized management strategy starts by understanding the heterogeneity of the COPD syndrome.

Description:

It is altogether appropriate that we acknowledge the founders of the field of pulmonary rehabilitation, a highly effective therapy for patients with chronic lung disease. This lecture will review the evolution of pulmonary rehabilitation as its physiologic basis was elucidated. Recent developments will also be reviewed and linked to their historical context.

Learning Objectives:

•Recognize the early innovators who defied the common conception that exercise was to be avoided in dyspneic patients with chronic respiratory disease.

•Review how the physiologic benefits of rehabilitative exercise programs were established.

•Consider the implications of the growing scarcity of in-center rehabilitation programs.

Description:

Obesity hypoventilation syndrome is a relatively common cause of chronic hypercapnic respiratory failure and can occur with or without obstructive sleep apnea, yet the optimal approach to treatment is not well defined. This will be a case-based interactive session that will review current diagnostic criteria, recent literature and guidelines and various management strategies. During this session, the faculty and attendees will also review the role of CPAP and more advanced nocturnal ventilatory modalities on outcomes in patients with OHS.

Objectives:

•Define obesity hypoventilation syndrome (OHS) and diagnostic approaches.

•Understand the most recent literature and guidelines related to the management of OHS.

•List different management strategies, including the use of various nocturnal ventilatory modes, that may improve outcomes in this patient population.