56th AARC International Respiratory Congress

Wednesday, December 8

37th Donald F Egan Memorial Lecture—
“The Mechanical Ventilator: Past, Present, and Future”

by Robert M Kacmarek PhD RRT FAARC

The Egan Lecture yesterday reviewed the history of mechanical ventilators and covered not only their physical development but described the clinical decisions that have influenced changes in them. It took the listener from the initial mechanical ventilator to the sophisticated ventilators available today and speculated on the future developmental needs of the mechanical ventilator.

The mechanical ventilator is the single most identifiable piece of equipment or therapy that is associated with respiratory care. In fact, the continued development and refinement of the mechanical ventilator has been the basis for the development and refinement of the profession of respiratory therapy.

In the beginning, mechanical ventilators were very simple mechanical devices that essentially provided only controlled mechanical ventilation. Today’s sophisticated microprocessor-controlled ventilators barely resemble their ancestors. The ventilator of today can provide virtually any mode of ventilation imaginable. It is able to monitor numerous functions of the patient and the ventilator itself, and its gas delivery systems are markedly improved over that of earlier generations of mechanical ventilators.

However, there is still room for improvement.

The ventilator of the future needs to address a number of important issues. It will be capable of providing ventilation to patients of all ages equally as well and be capable of providing invasive and noninvasive ventilation with equal efficacy. It will provide decision support at all levels. When an alarm sounds, the ventilator will be able to define the potential causes of the alarm and outline steps that should be taken to correct them.

The ventilator of the future will not simply present line after line of unrelated data; instead, it will provide the clinician with information that can be used to improve the process of mechanical ventilation. If the airway pressure is slowly increasing over time and the compliance is slowly decreasing, the future ventilator will plot this data illustrating the detrimental trend and provide the potential actions needed to reverse or correct the trend. Emphasis during gas delivery will focus not just on lung protection but on patient-ventilator interaction. The ventilator on an ongoing basis will identify the level and type of asynchrony and automatically adjust gas delivery where possible to improve synchrony. Modes of ventilation will focus on improving synchrony, since we will increasingly discover that asynchrony has a markedly negative impact on patient outcome.

The singular word that will be used to describe the ventilator of the future is smart!

AARC Installs 2011 Officers and Directors

The Association’s 2011 officers and directors were installed during the AARC Annual Business Meeting held yesterday at the Congress.

Please welcome these recently elected officials to their new positions: Susan Rinaldo-Gallo, MEd, RRT, FAARC, vice president of internal affairs; George Gaebler, MSEd, RRT, FAARC, vice president of external affairs; Linda Van Scoder, EdD, RRT, FAARC, secretary-treasurer; and directors-at-large Fred Hill, Jr., MA, RRT; Denise Johnson, BS, RRT; and Camden McLaughlin, BS, RRT, FAARC.

These specialty sections also held elections this year, and these individuals were elected: Keith Lamb, RRT, Adult Acute Care; Matthew O’Brien, BA, RRT, RPFT, Diagnostics; Joseph Sorbello, MSEd, RRT, Education; Bill Cohagen, BA, RRT, FAARC, Management; and Cynthia White, BA, RRT-NPS, Neonatal-Pediatrics.

New House of Delegates officers include Billy M. Lamb, BS, RRT, FAARC, speaker; Karen Schell, MHS, RRT-NPS, RPFT, speaker-elect; Sheri Tooley, BS, RRT-NPS, CPFT, secretary; and William Pupanek, RRT, treasurer.

The Annual Meeting also featured the president’s address and the AARC 2011 forecast, presented by incoming president Karen J. Stewart, MSc, RRT, FAARC, along with reports from the Association secretary-treasurer, executive director, and other officials.

Roche 5-K Fun Run and Walk Proved To Be a Great Way To Start the Day

Hundreds of Congress attendees got up early yesterday morning for the Roche 5-K Fun Run and Walk. The annual event gave everyone the chance to begin their day with a healthy outdoor activity that really got the juices flowing for the educational sessions to follow.

Kittredge Lecturer Has Another Claim to Fame

Stephen I. Rennard, MD, is sharing exciting news about the developing scientific evidence on COPD heterogeneity and how it will figure into our practice of respiratory care in the future in today’s Phil Kittredge Memorial Lecture.

But Dr. Rennard has another claim to fame as well. He’s the author of a 2000 study in CHEST titled “Chicken Soup Inhibits Neutrophil Chemotaxis In Vitro” that helped to prove what your grandmother has always known: Chicken soup really is good for a cold. You can find out much more about this intriguing study, and even watch a video of Dr. Rennard and his wife preparing the soup, on the University of Nebraska Medical Center’s Chicken Soup Research website.

Thanks to ARCF Reviewers!

The American Respiratory Care Foundation (ARCF) presented a long list of awards during the Awards Ceremony on Monday. None of them, however, would have been possible without the dedicated reviewers who helped to review all of the applications that came in this year. The ARCF would like to take this opportunity to thank its 2010 reviewers:

• Brian Parker, MPH, RRT-NPS, RPFT
• Douglas Masini, EdD, RRT-NPS, FAARC
• Pat Munzer, MS, RRT, FAARC
• Kerry George, MEd, RRT, FAARC
• Jeffrey Ward, MEd, RRT, FAARC
• Randy De Kler, MS
• Robert Tralongo, MBA, RRT-NPS, CPFT
• Terry Volsko, MHS, RRT, FAARC
• Linda Van Scoder, EdD, RRT, FAARC
• Laverne Yousey, RRT
• Erna Boone, MEd, RRT
• Julianne Perretta, MSEd, RRT-NPS
• Shawna Strickland, PhD, RRT-NPS, AE-C
• Dennis Wissing, PhD, RRT, FAARC
• Robert Fluck, Jr., RRT, FAARC
• Jeffery Ludy, EdD, RRT
• Stacia Biddle, MEd, RRT
• Thai Nguyen, RRT
• Charlie Brooks, MEd, RRT, FAARC
• Robert Joyner, Jr., PhD, RRT, FAARC
• Glenn Kellar, BS, RRT, CPFT
• Stephen Swope, BA, RRT
• Sharon Hatfield, PhD
• Jody Lester, MA, RRT

Your Foundation Supports Your Practice

Congress attendees watched as many of their colleagues received much-deserved honors and awards for outstanding scholarship, research, and literary works at the Awards Ceremony on Monday. The vast majority of these scholarships and awards are made possible every year by your American Respiratory Care Foundation. If you would like to learn more about the ARCF’s 2011 awards, go online to ARCFoundation.org to see what’s available. You’ll find submission information, application deadlines, and more.

AARConnect: Your Direct Line to 50,000 Colleagues

Earlier this year the AARC journeyed into the brave new world of social media with its very own social networking website, AARConnect. Congress attendees have been getting help setting up their profiles and uploading pictures in the AARC booth all week, but the process is really fairly easy. If you haven’t visited the site yet, go to AARConnect and see what you’ve been missing! In addition to setting up your own profile page, you’ll be able to network with your 50,000 colleagues in the AARC via blogs, discussion lists, resource libraries, and more.

AARC Industry Support Statement

The AARC is proud of the collaboration we have had with friends in industry for many years, and we wish to acknowledge our appreciation for their unrestricted educational grants for the AARC International Respiratory Congress. All sponsored sessions are identified by the program, handouts, and signage. The AARC accepts support only on the condition that the Program Committee be the sole organizer of all sessions, including selection of speakers and topics.

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