ATS 2019 Virtual Final Program

BEHAVIORAL • CLINICAL CRITICAL CARE TRACK CME Credits Available: 2 B84 CAN’T STOP OR WON’T STOP: THE ROLE OF CLINICAL INERTIA IN CRITICAL CARE MEDICINE Assemblies on Critical Care; Behavioral Science and Health Services Research; Nursing 2:15 p.m. - 4:15 p.m. OMNI DALLAS DOWNTOWN Dallas Ballroom D/H (Level 3) Target Audience Critical care clinicians, trainees, clinical researchers Objectives At the conclusion of this session, the participant will be able to: • understand how clinical inertia evolves in critical illness; • recognize the ethical and emotional considerations related to clinical inertia; • identify tools to address clinical inertia in routine clinical practice and be able to apply them. Consider the following case: Day 0: elective surgery; Day 1: cardiac arrest; Day 3: ARDS; Day 4: renal replacement therapy; Day 17: tracheostomy; Day 18: feeding tube; Day 21: discharge to LTAC. We’ve all taken care of such patients, where one event leads to the next, and continuing to simply add more treatments becomes easier than considering alternate pathways, and a downhill spiral ensues. To advance patient-centered care, we must identify key moments in a patient’s course to stop and re-consider the trajectory of care and the patient’s goals. This session will examine the concept of clinical inertia and role it plays in our care of critically ill patients-from ICU admission decisions, through hospitalization, and beyond. Leading experts will discuss the longitudinal evolution of critical illness, the role of clinical inertia in clinical decision making, tools to recognize clinical inertia, and strategies to address the consequences of clinical inertia. Chairing: E.M. Viglianti, MD, MPH, MSc, Ann Arbor, MI J.M. Kruser, MD MS, Chicago, IL S.S. Carson, MD, Chapel Hill, NC 2:15 The Marathon No One Prepares You For: The Perspective of a Caregiver M. Hurley, Austin, TX 2:30 Why Don’t We Stop? Clinical Momentum and Decision Making in the ICU J.M. Kruser, MD MS, Chicago, IL 2:45 Withholding vs Withdrawing: Is There a Difference? G.D. Rubenfeld, MD, MSc, Toronto, Canada 3:00 Nudging Clinical Inertia: Living Wills and Advanced Directives J. Hart, MD, MS, Philadelphia, PA 3:15 2 Weeks in ...Will This Patient Ever Leave the ICU? E.M. Viglianti, MD, MPH, MSc, Ann Arbor, MI 3:30 How Should We Incorporate Palliative Care in the ICU? S.S. Carson, MD, Chapel Hill, NC 3:45 Reflecting on the Other End J.A. McPeake, RN, PhD, Glasgow, United Kingdom 4:00 Is It All About the Patient: What Do We Know and What Can We Learn About Caregiver Burden After Critical Illness M.S. Herridge, MD, MPH, MSc, Toronto, Canada BASIC • CLINICAL • TRANSLATIONAL BASIC SCIENCE CORE CME Credits Available: 2 B85 THEY’VE GOT THE BEAT: CILIA IN DEVELOPMENT AND DISEASE Assemblies on Respiratory Cell and Molecular Biology; Pediatrics; Respiratory Structure and Function 2:15 p.m. - 4:15 p.m. KBHCCD Ballroom D Two (Level 3) Target Audience Basic scientists, clinicians, students and postdoctoral trainees, and providers working in pediatric, neonatal, or adult lung disease who are interested in understanding how cilia impact lung development and a spectrum of lung diseases Objectives At the conclusion of this session, the participant will be able to: • provide the latest updates in the genetic and transcriptional control of cilia fate decisions in airway ciliogenesis; • improve knowledge of the cellular signaling mechanisms regulating ciliogenesis in health and disease; • improve understanding of the association of airway ciliopathies and other diseases. Ciliary function has critical implications for lung development and impaired mucociliary clearance is a fundamental feature of many inherited and acquired respiratory diseases including PCD, asthma, chronic bronchitis, and CF. In order to improve diagnosis and develop effective treatments, there is a critical need to understand the cellular signaling components that govern cell fate decisions and functional maturation. This session will provide the latest information on the cellular, molecular, and genetic mechanisms that govern cell fate decisions and ciliary function, with application to a spectrum of lung diseases in adults and children. Chairing: A.L. Ryan, PhD, Los Angeles, CA E.K. Vladar, PhD, Aurora, CO S.L. Brody, MD, ATSF, Saint Louis, MO 2:15 Introduction to Motile Cilia in Health and Disease S.L. Brody, MD, ATSF, Saint Louis, MO 2:30 A Patient's Perspective W. Anton, Chicago, IL 2:55 Identification of Cilia-Specific Gene Signatures and SNPs Driving Lung Disease M.A. Seibold, PhD, Denver, CO 3:15 Identification of Novel Mutations Driving Primary Ciliary Dyskinesia H. Omran, MD, Muenster, Germany 3:35 Alcohol Induced Ciliary Dysfunction: An Oxidant-Driven Acquired Ciliopathy J.H. Sisson, MD, Omaha, NE ATS 2019 • Dallas, TX 200 MONDAY • MAY 20