ATS 2020 Advance Program

Chairing: K.M. Wille, MD, MSPH, Birmingham, AL C. Quill, MD, Rochester, NY A.L. Gray, MD, Aurora, CO 8:45 Defining and Managing Medical Futility in Advanced Heart and Lung Disease F. Rincon, MD, MSc, Philadelphia, PA 9:05 The Ethics of Health Care Rationing: From Medication Shortages to ICU Resources G.L. Anesi, MD, MSCE, MBE, Philadelphia, PA 9:25 Emerging Ethical Challenges with the Use of Extracorporeal Life Support C. Agerstrand, MD, New York, NY 9:45 The Ethics of Physician-Assisted Suicide and Euthanasia in the ICU E.C. Goligher, MD, PhD, Toronto, Canada 10:05 Incorporating Ethics Consultation into the Care of the Advanced Heart or Lung Disease Patient J. McCannon, MD, Cambridge, MA 10:25 Recognizing and Managing Provider Distress Arising From Complex Ethical Dilemmas Speaker To Be Announced CLINICAL CLINICAL TOPICS IN PULMONARY MEDICINE D3 STATE OF THE ART IN RESPIRATORY CARE OF NEUROMUSCULAR DISEASE FROM PEDIATRICS TO ADULT: LIVING LONGER AND LIVING BETTER Assemblies on Clinical Problems; Pediatrics; Sleep and Respiratory Neurobiology 8:45 a.m. - 10:45 a.m. Target Audience Adult and pediatric pulmonary and sleep physicians and mid-level providers working with patients with neuromuscular respiratory failure, nurses and respiratory therapists. Objectives At the conclusion of this session, the participant will be able to: • recognize hypoventilatory respiratory insufficiency associated with neuromuscular disease, with a goal of early diagnosis and implementation of assistive devices before overt respiratory failure, by disease stage; • anticipate perioperative changes, and adapt the assistive device usage to prevent respiratory complications while allowing appropriate surgical interventions; • understand the importance of transitions; from Pediatric to Adult Pulmonologists, and at end of life. Key concepts include communication, disease understanding, expectations and recognition of crisis points distinct from dying. Patients with pediatric neuromuscular disorders (muscular dystrophies, spinal muscular atrophy,metabolic myopathies) are surviving longer, and are requiring adult pulmonary providers to effectively transition care. The adult onset neuromuscular disorders are also increasing in prevalence (amyotrophic lateral sclerosis) and survival with advancing technologies in airway clearance and non-invasive ventilation (NIV). The session will address recognition of hypoventilatory respiratory insufficiency, implementation of stage specific respiratory assistive devices to maximize patient independence, quality of life and survival, and safely managing operative needs (routine and disease specific) after onset of respiratory insufficiency, bridging pediatric providers to adult pulmonary care and end of life issues. Chairing: K.A. Provost, DO, PhD, Buffalo, NY M. Cao, DO, Redwood City, CA J.O. Benditt, MD, Seattle, WA 8:45 Avoiding the Cliff Fall: Recognizing and Understanding the Mechanics and Progression of Hypoventilation in Neuromuscular Respiratory Insufficiency M. Cao, DO, Redwood City, CA 9:01 Panel Discussion 9:03 School, Camping, Sport and Travel: Maintaining Quality of Life by Implementation of Non-Invasive Ventilation by Disease Stage K.A. Provost, DO, PhD, Buffalo, NY 9:19 Panel Discussion ATS 2020 • Philadelphia, PA WEDNESDAY • MAY 20 125