Mayo Clinic Mechanical Ventilation Conference 2022

Upon conclusion of this program, participants should be able to

• Outline the physiologic principles and cardiopulmonary interactions underlying the risks, benefits, and applications of ventilator support for respiratory failure.
• Describe in detail the use of different modes of ventilator support for patients with respiratory failure.
• Demonstrate appropriate use of mechanical ventilation equipment following participation in hands-on workshop.
• Integrate pulmonary mechanics at the bedside in personalized approach to mechanical ventilation.

Program

Day 1 –

Registration and Continental Breakfast

Welcome, Overview and Announcements

Lectures: Basics Physiologic Principles: Understanding Mechanical Ventilation

Reconciling Physiology and Evidence-based Medicine in Respiratory Care: Lessons Learned During the Pandemic Jean-Louis Vincent, M.D., Ph.D.

Basic Modes of Ventilation: Pressure vs. Flow Regulation Neil R. MacIntyre, Jr, M.D.

Patient-Ventilator Dyssynchrony and Wave Form Analysis Steven R. Holets, R.R.T, L.R.T.

Refreshment Break and Exhibits

Breakout Sessions: Intensive Tutorials, Case Discussions, Introductory Workshops

Intensive Tutorials Select ONE of these sessions (90 minutes):

1. Lung Protective Mechanical Ventilation: The role of PEEP today-Pros & Cons John J. Marini, M.D.
2. Advanced Options and Non-standard Modes: Does the mode make a difference? – Pros and Cons Nader M. Habashi, M.D. and Richard Kallet, MS, R.R.T., FAARC
3. The Golden Hour of Mechanical Ventilation: Transitioning Respiratory Care from the Emergency Department to the ICU JuneMee Chae, M.D.
4. “Catch The Wave” – Wave Form Analysis and Patient-Ventilator Dyssynchrony Steve R. Holets, R.R.T., L.R.T.

OR select TWO of the following (45 minutes each):

Case Discussions 5. A Systematic Approach to Refractory Hypoxemia – the Mayo Model Richard A. Oeckler, M.D., Ph.D.

6. Inability to Ventilate – Airway Obstruction and High Airway Pressures William M. LeTourneau II, R.R.T., L.R.T. and William Clark, R.R.T., L.R.T.
7. Taking ownership of invasive and noninvasive ventilation devices – How to Manage and Troubleshoot Tanner J. Hill, R.R.T., L.R.T. and Cheryl A. Paulson, R.R.T., L.R.T.

Introductory Workshops 8. The ABC’s of Prone Positioning: When, Why and How Alice Gallo De Moraes, M.D., Jennifer L. Elmer, APRN, CNS, D.N.P., Andrea T. Lehnertz, APRN, CNS. M.S.N., Holly D. Behrns, R.R.T., L.R. T.

9. Ventilation Adjuncts – Tubes, Aerosols and Clearance Bhargavi Gali, M.D.
10. Lung Recruitment and Setting PEEP: Is My Patient’s Lung Recruitable? Giacomo Bellani, M.D.

Lunch and Exhibits Lectures:

• Monitoring During Mechanical Ventilation Excessive Respiratory Drive in COVID-19: How to monitor and Treat? Giacomo Bellani, M.D. COVID-19 Associated ARDS Phenotypes: Leading or Misleading? Luigi Camporota, M.D. Patient Self-Inflicted Lung Injury (PSILI): Timing of Intubation Laurent J. Brochard, M.D. Refreshment Break and Exhibits Breakout Sessions: Intensive Tutorials, Case Discussions, Introductory Workshops Intensive Tutorials Select ONE of these sessions: 1.Mechanical Ventilation Guided by Esophageal Pressure James E. Baker, R.R.T., L.R.T. and Tanner J. Hill, R.R.T., L.R.T. 2.Monitoring Diaphragmatic Activity and Respiratory Efforts Laurent J. Brochard, M.D. 3.Mobilizing the Mechanically Ventilated Patient on ECMO Shannon E. Vold, P.T., D.P.T. and Ashley G. Elkins, O.T. 4.Airway Management and Ventilatory Support in Pediatrics Devon Aganga, M.D. and Christopher Bosley, R.R.T., L.R.T. OR select TWO of the following: Case Discussions

5. Managing the obese patient: Obesity and Other Disorders of the Chest Wall Bhargavi Gali, M.D.
6. Integration of Pulmonary Mechanics –Transpulmonary and Airway Driving Pressure Richard A. Oeckler, M.D., Ph.D.
7. Ventilator Use at Home: Ventilatory Support Peter C. Gay, M.D. Introductory Workshops
8. Controlled Vs. Spontaneous Ventilation in ARDS: When and How? Luigi Camporota, M.D.
9. Lungs in a Box: Ex vivo lung perfusion (EVLP) for lung transplantation Jorge Mallea, M.D.
10. “Catch the Wave” – Wave Form Analysis and Patient-Ventilator Dyssynchrony William M. LeTourneau II, R.R.T. L.R.T. Get to Know the Experts- Q&A Moderated by Jean-Louis Vincent, M.D., Ph.D. Adjourn

Day 2 – Friday, September 16, 2022 7:15 am Continental Breakfast Lectures: Hypoxia 8:00 am A Pragmatic Approach to Lung Recruitability: Why, When and How? Neil R. MacIntyre Jr., M.D. 8:30 am How I optimize Mechanical Power to avoid VILI Luciano Gattinoni, M.D. Virtual Participation 9:00 am Neuromuscular Blockade in the ARDS: Who, When and How Long? Laurent J. Brochard, M.D. 9:30 am Refreshment Break and Exhibits 10:00 – 11:30 Breakout Sessions: Intensive Tutorials, Case Discussions, Introductory Workshops

Intensive Tutorials Select ONE of these sessions (90 minutes):

1. How to optimize Mechanical Power to avoid VILI: A practical workshop John J. Marini, M.D.
2. Extra-Corporeal Life Support –Indications, Initial Evaluation and Implementation Suraj Yalamuri, M.D.
3. The Golden Hour of Mechanical Ventilation: Transitioning Respiratory Care from the Emergency Department to the ICU JuneMee Chae M.D.
4. Refractory Hypoxemia –A Systematic Approach Richard A. Oeckler, M.D., Ph.D.

OR

Select TWO of the following (45 minutes each):

Case Discussions 5. Taking ownership of invasive and noninvasive ventilation devices –How to Manage and Troubleshoot Tanner J. Hill, R.R.T., L.R.T., and Cheryl A. Paulson, R.R.T., L.R.T.

6. Managing the obese patient: Obesity and Other Disorders of the Chest Wall Bhargavi Gali, M.D.
7. Non-Invasive Ventilatory Support in ARDS Bernardo Selim, M.D. and Christine Kelm, R.R.T., L.R.T.

Introductory Workshops 8. The ABC’s of Prone Positioning: When, Why and How Alice Gallo De Moraes, M.D., Jennifer L. Elmer, APRN, CNS, D.N.P., Andrea T. Lehnertz, APRN, CNS. M.S.N., Holly D. Behrns, R.R.T., L.R. T.

9. Bedside Assessment of Auto-PEEP, and Lung Stress and Strain – What should we monitor in the ventilated patient and when? Neil R. MacInytre Jr, M.D.
10. Setting PEEP and Bedside Assessment of Lung Recruitability Richard Kallet, MS, R.R.T., FAARC

11:30 am Lunch and Exhibits

Lectures: Ventilation

12:30 pm Liberation from Mechanical Ventilation Richard Kallet, MS, R.R.T., FAARC 1:00 pm HFNC and NIV in Hypoxemic-hypercapnic Respiratory Failure: Optimizing NIV Settings Bernardo Selim, M.D. 1:30 pm Allocation of Ventilatory Support During the COVID-19 Pandemic Erin DeMartino, M.D. 2:00 pm Management of ARDS: What is Really Evidence-based? Jean-Louis Vincent, M.D., Ph.D. 2:30 pm Refreshment Break and Exhibits

3:00 – 4:30 pm Breakout Sessions: Intensive Tutorials, Case Discussions, Introductory Workshops

Intensive Tutorials Select ONE of these sessions (90 minutes):

1. How to optimize Mechanical Power to avoid VILI: A practical workshop John J. Marini, M.D.
2. Mechanical Ventilation in Asthma and COPD Steven R. Holets, R.R.T., L.R.T.
3. Extra-Corporeal Life Support – Indications, Initial Evaluation and Implementation Suraj Yalamuri, M.D.
4. Mechanical Ventilation Guided by Esophageal Pressure James E. Baker, R.R.T., L.R.T. and Tanner J. Hill, R.R.T., L.R.T.

OR Select TWO of the following (45 minutes each): Case Discussions

5. Airway Pressure Release Ventilation (APRV) in the treatment of ARDS Nader M. Habashi, M.D.
6. Integration of Pulmonary Mechanics –Transpulmonary and Airway Driving Pressures Richard Kallet, MS, R.R.T., FAARC
7. Non-Invasive Ventilatory Support in ARDS Bernardo Selim, M.D., and Christine Kelm, R.R.T., L.R.T.

Introductory Workshops 8. Controlled Vs. Spontaneous Ventilation in ARDS: When and How? Luigi Camporota, M.D.

9. Lungs in a Box: Ex vivo lung perfusion (EVLP) for Lung Transplantation Jorge Mallea, M.D.
10. Setting PEEP and Bedside Assessment of Lung Recruitability Giacomo Bellani, M.D.

4:30 Get to Know the Experts- Q&A Moderated by John J. Marini, M.D. 5:00 Adjourn

Day 3 – Saturday, September 17, 2022
7:15 am
Continental Breakfast
Master Class Series:
Advances in Respiratory Failure Management
8:00 am
Practical Approach to Mechanical Ventilation during ECMO – Why and How? Suraj Yalamuri, M.D.
8:30 am
Monitoring Regional Ventilation in Hypoxemic Respiratory Failure – the role of electrical impedance tomography Laurent J. Brochard, M.D.
9:00 am
Should we adopt “Open Lung” approach for all? John J. Marini, M.D.
9:30 am
Refreshment Break and Exhibits
10:00 am
Mechanical Power and Positive End-Expiratory Pressure – What is the real mechanical cause of VILI? Luciano Gattinoni, M.D. Virtual Participation
10:30 am
Who gets to be proned and how often? Giacomo Bellani, M.D.
11:00 am
Artificial Intelligence and The Future of Respiratory Care Jean-Louis Vincent, M.D., Ph.D.
11:30 am
Pros & Cons Summary Debate Gustavo A. Cortes Puentes, M.D. and Inga Forde, M.D.
12:30 pm
Adjourn