31st Annual Conference on High Frequency Ventilation of Infants, Children & AdultsTUESDAY, MARCH 25 - SATURDAY, MARCH 29, 2014

THE CLIFF LODGE, SNOWBIRD, UT

31st Conference on High Frequency Ventilation of Infants, Children and Adults

March 25-29, 2014 Snowbird Conference Center

Highway 210, Little Cottonwood Canyon Snowbird, Utah

Tuesday, March 25, 2014

Time Title and Speaker

3:00 PM Registration

Moderator: Donald M. Null, Jr., MD; Professor of Pediatrics, Director of Clinical Services, University of Utah, Salt Lake City, UT

5:00 PM Open Remarks Donald M. Null, Jr., MD; Professor of Pediatrics, Director of Clinical Services, University of Utah, Salt Lake City, UT

5:15 PM PRESENTATION Technology, Quality, and Safety: Where do we draw the line? Mitchell Goldstein, MD; Loma Linda University Children’s Hospital, Loma Linda, CA

6:15 PM Adjourn

Wednesday, March 26, 2014

Time Title Speaker 7:00 AM Registration and Breakfast

Moderator: Stephen Derdak, DO, Wilford Hall Medical Center, USAF, Lackland, AFB San Antonio, TX

8:00 AM

SPECIAL LECTURE Neonatal Analgesia: Optimal Use Robert M. Ward, MD, FAAP, FCP, Professor Pediatrics, Attending Neonatologist, Adjunct Professor, Pharmacology/Toxicology, University of Utah School of Medicine, Salt Lake City, UT

9:00 AM Identifying Patterns in Time Series Data: Using Neural Networking to Predict the Continued Presence of Normal Variation in High Frequency Ventilation Mitchell Goldstein, MD; Loma Linda University Children’s Hospital, Loma Linda, CA

9:15 AM Using Pulse Oximetry to Monitor Frequency Oscillation Mitchell Goldstein, MD; Loma Linda University Children’s Hospital, Loma Linda, CA

9:30 AM A New Paradigm for Oxygenation Index (OI) in Neonates Mitchell Goldstein, MD; Loma Linda University Children’s Hospital, Loma Linda, CA

9:45 AM Intermittent Mandatory Ventilation for 3 Days Leads to Lower Capillary Surface Capillary Density in Renal Outer Cortex of Preterm Lambs Eveline Staub, MD; University of Utah School of Medicine, Salt Lake City, UT

10:00 AM Break

10:20 AM

Intermittent Mandatory Ventilation for 3 Days Leads to More Expression of Insulin-Like 1 Growth Factor Binding Protein 5 in the Renal Cortex of Preterm and Former Lambs Eveline Staub, MD; Division of Neonatology Research Fellow, University of Utah School of Medicine, Salt Lake City, UT

10:35 AM Intermittent Mandatory Ventilation for 3 Days Alters Histone Modifications in the Renal Cortex of Preterm and Former Preterm Lambs Adam Blair; University of Utah School of Medicine, Salt Lake City, UT

10:50 AM

Intermittent Mandatory Ventilation for 21 Days Leads to Less EphrinB1 Ligand Protein in the Brain of Lambs Kassidy R. Rinehart; Undergraduate Researcher, Albertine Lab, University of Utah, School of Medicine, Salt Lake City, UT

11:05 AM

SPECIAL LECTURE Mechanical Ventilation: It Doesn’t Do a Body Good! Bradley Yoder, MD; Professor of Pediatrics, Medical Director NICU, University Hospital, University of Utah School of Medicine, Salt Lake City, UT

12:05 PM Adjourn – Afternoon Free

Moderator: Donald M. Null, Jr., MD; Professor of Pediatrics, Director of Clinical Services, University of Utah, Salt Lake City, Utah

5:00 PM Beyond 15Hz, Is it good? Is it feasible? Jon MR Jam, MD; Loma Linda University Medical Center, Loma Linda, CA

5:20 PM Intermittent Mandatory Ventilation for 3 Days Does Not Lead to Persistent Changes in Genome-wide Histone Modifications in the Brain of Former Preterm Lambs Ashley Havlicak; Senior Lab Assistant, University of Utah School of Medicine, Salt Lake City, UT

5:40 PM

SPECIAL LECTURE Neutrophil Extracellular Trap Formation: Bedside to Bench and Back Again Christian Con Yost, MD; Associate Professor – Pediatrics/Neonatology, University of Utah School of Medicine, Salt Lake City, UT

6:30 PM

A Dummy’s Guide to Lung Mechanics or How to Adjust HFV Settings to Prevent and Treat Lung Injury J. Bert Bunnell, ScD, FAIMBE; Chairman, Bunnell Inc. and Adjunct Associate Professor, Bioengineering, University of Utah, Salt Lake City, UT

7:10 PM Adjourn

Thursday, March 27, 2014

Time Title Speaker 7:00 AM Registration and Breakfast

Moderator: Arun Pramanik, MD, Louisiana State University Medical Center, Shreveport, LA

8:00 AM

SPECIAL LECTURE Bedside Pulmonary Imaging to Guide Mechanical Ventilation: Dream or Reality? John H. Arnold, MD; Professor of Anesthesia (Pediatrics); Harvard Medical School, Senior Associate, Anesthesia and Critical Care, Medical Director, Respiratory Care, ECMO / Biomedical Engineering, Children’s Hospital, Boston, MA

9:00 AM High Frequency Workshop I 9:55 AM Break

10:15 AM High Frequency Workshop II 11:10 AM High Frequency Workshop III 12:05 PM Adjourn – Afternoon Free

Moderator: Donald M. Null, Jr., MD; Professor of Pediatrics, Director of Clinical Services, University of Utah, Salt Lake City, UT

5:00 PM Nitric Oxide Delivery with the VDR Chris Benitez; Primary Children’s Hospital, Salt Lake City, UT

5:15 PM Critical Care Ultrasound: Evolving Applications in Critical Care Practice Stephen Derdak, DO; Wilford Hall Medical Center, USAF, Lackland, AFB, San Antonio, TX

5:50 PM Presentation of the 22nd Annual Jimmy Schulz Award Presentation of the 17th Annual Jack Emerson Award

6:00 PM

SPECIAL LECTURE 17th Robert deLemos Memorial Lecture Do The Good You Are Called To Do Reese Clark, MD; Vice-President and Co-Director, The Center for Research, Education, and Quality, Pediatrix Medical Group; Neonatologist, Greenville Memorial Hospital, Greenville, SC

7:00 PM Adjourn

Friday, March 28, 2014

Time Title Speaker 7:00 AM Registration and Breakfast

Moderator: Arun Pramanik, MD; Louisiana State University Medical Center, Shreveport, LA

8:00 AM Mid Frequency vs HFJV – Does MV and C02 wash out matter? Kevin Crezee, BS, RRT-NPS, Respiratory NICU Coordinator, Primary Children’s Hospital, Salt Lake City, UT

8:20 AM ETTC CO2 Monitoring with HFOV, A Bench Study. Jeffrey Wright, BS, RRT-NPS, Critical Care Respiratory Care Practitioner, Primary Children’s Hospital, Salt Lake City, UT

8:40 AM

High Frequency Percussive Ventilation (HFPV) Rescue for Severe Hypoxic Respiratory Failure in Neonates Kevin Crezee, BS, RRT-NPS, Respiratory NICU Coordinator, Primary Children’s Hospital, Salt Lake City, UT

9:00 AM Use of Volumetric Diffusive Respiration in the Pediatric Intensive Care Unit Daniel Tawfik, MD; Division of Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT

9:20 AM ASL 5000 Lung Model Fails to Simulate Preset Mechanical Parameters during HFJV and Volume Control Ventilation with a Decelerating Flow Waveform Karel Roubik; Czech Technical University, Prague, Czech Republic

9:40 AM Break

10:10 AM VDR Phasitron’s Performance Variation with a Conventional Ventilator Circuit C. Jeffrey Hoydu MBA, RRT; Director Respiratory Care Services, Primary Children’s Hospital, Salt Lake City, UT

10:35 AM Anatomy of the VDR Breath Kevin Crezee, BS, RRT-NPS, Respiratory NICU Coordinator, Primary Children’s Hospital, Salt Lake City, UT

11:00 AM

SPECIAL LECTURE VDR – Strategies for use – Pathophysiology Matters Donald M. Null, Jr., MD; Professor of Pediatrics, Director of Clinical Services, University of Utah, Salt Lake City, UT

12:00 PM Adjourn – Afternoon Free

Moderator: Stephen Derdak, DO, Wilford Hall Medical Center, USAF, Lackland, AFB San Antonio, TX

5:00 PM

SPECIAL LECTURE Minimally Invasive Extracorporeal Life Support for Lung Failure. What it is and what it isn’t Andriy Batchinsky, MD; Senior Research Scientist, U.S. Army Institute of Surgical Research, Associate Professor of Surgery, University of Texas Health Science Center, San Antonio, TX

6:00 PM SPECIAL LECTURE HFOV in Large Patients: How we do it – from soup to nuts Stephen Derdak, DO, Wilford Hall Medical Center, USAF, Lackland, AFB, San Antonio, TX

7:00 PM HFVP vs Tele Medicine: Are they kidding? Guido Sarduci, Roma, Italy

7:15 PM Adjourn

Saturday, March 29, 2014

Time Title Speaker 7:00 AM Registration and Breakfast

Moderator: Stephen Derdak, DO, Wilford Hall Medical Center, USAF, Lackland, AFB San Antonio, TX

8:00 AM The Use of High Frequency Jet Ventilation in a Neonate Following Surgical Resection of Congenital Cystic Adenomatoid Malformation: A Case Report Craig Wheeler, RRT-NPS; Boston Children’s Hospital, Boston, MA

8:20 AM

Elevated IGF-1 Leads to Alveolar Simplification in the Lung of Preterm Lambs Supported By Intermittent Mandatory Ventilation for 3 Days Mar Janna Dahl, MS; Lab Director, Albertine Lab, Department of Pediatrics, Division of Neonatology, University of Utah, Salt Lake City, UT

8:40 AM

SPECIAL LECTURE Tele Critical Care Medicine: Where are we? Where are we going? William Beninati, MD; Critical Care Physician, Intermountain LDS Hospital; Medical Director, Intermountain TeleCritical Care and Intermountain Life Flight Adult Service; Clinical Assistant Professor of Medicine, University of Utah School of Medicine, Salt Lake City, UT

9:40 AM Break

1000 AM

SPECIAL LECTURE How Should We Manage the Lung on ECMO? Donald M. Null, MD; Professor of Pediatrics, Director of Clinical Services, University of Utah School of Medicine, Salt Lake City, UT

11:00 AM Conference Summary and Closing Remarks 11:15 AM Adjourn and Program Evaluation

Purpose Join us in beautiful Snowbird, Utah, as we enhance the knowledge and skills of physicians, registered nurses, nurse practitioners, and respiratory therapists in the use of high frequency ventilation and related modalities in the management of severe respiratory problems. Using both didactic lectures and hands-on learning experience this conference provides a forum to stimulate research questions and encourage participants to pursue and present that research at an upcoming High Frequency Ventilation Conference. Objectives Upon completion of this activity participants should be able to:

• Discuss the use of nitric oxide in the management of persistent pulmonary hypertension • Review the criteria for lung transplantation in neonatal and pediatric patients and

their outcomes • Identify the fundamentals of using aerosol medications during high

frequency ventilation

Exhibitors - Please remember to visit them in the Magpie Room

• Bunnell, Inc. • CareFusion • Cornerstone Therapeutics Inc. • Draeger Medical • Ikaria • MedImmune • Percussionaire Corporation

Disclosure has been made by the faculty and is available for review in the syllabus. We are recommending the use of patient treatment plans not individual products that may be used in patient treatment.

Disclosure information John H. Arnold, MD Professor of Anesthesia (Pediatrics), Harvard Medical School, Senior Associated, Anesthesia and Critical Care Medical Director, Respiratory Care, ECMO/Biomedical Engineering, Children's Hospital, Boston, MA Faculty: Mr. Arnold has indicated that he has a financial relationship with Maquet, Inc and Drager. Andriy Batchinsky, MD Senior Research Scientist, U.S. Army Institute of Surgical Research, Associate Professor of Surgery, University of Texas Health Science Center, San Antonio, TX Faculty: Dr. Batchinsky has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. William Beninati, MD Critical Care Physician, LDS Hospital; Chair, Intermountain Critical Care Development Team, Intermountain Healthcare; Clinical Assistant Professor of Medicine, University of Utah School of Medicine; Salt Lake City, Utah Faculty: Dr. Beninati has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Chris Benitz Educator, Respiratory Care Services, Primary Children's Hospital, Salt Lake City, Utah Faculty: Mr. Benitz has indicated that he has a financial relationship with Respirtech, Inc. Adam Blair Lab Assistant, University of Utah, School of Medicine, Salt Lake City, Utah Faculty: Mr. Blair has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. J. Bert Bunnell, ScD, FAIMBE Chairman, Bunnell Inc.; Adjunct Associate Professor, Bioengineering, University of Utah, Salt Lake City, Utah Faculty: Mr. Bunnell has indicated that he has a financial relationship with Bunnell Inc. Reese Clark, MD Vice-President and Co-Director, The Center for Research, Education, and Quality, Pediatrix Medical Group; Neonatologist, Greenville Memorial Hospital, Greenville, South Carolina Faculty: Dr. Clark has indicated he has no financial relationships to disclose relevant to the content of the CME activity.

Kevin Crezee, BS, RRT-NPS Respiratory NICU Coordinator, Primary Children’s Medical Center, Intermountain Healthcare; Neonatal, Pediatric Respiratory Team Lead, Intermountain LifeFlight, Salt Lake City, Utah Faculty/Planning Committee: Mr. Crezee has indicated he has a financial relationship with Ikaria and Discover Labs. Mar Janna Dahl, MS Lab Director, Albertine Lab, Department of Pediatrics, Division of Neonatology, University of Utah, Salt Lake City, Utah Faculty: Ms. Dahl has indicated she has no financial relationships to disclose relevant to the content of the CME activity. Stephen Derdak, DO Clinical Professor, San Antonio Military Medical Center, Lackland Air Force Base, Texas Faculty/Planning Committee: Dr. Derdak has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Mitchell Goldstein, MD, FAAP Associate Professor, Department of Pediatrics, Loma Linda University Children’s Hospital, Loma Linda, California Faculty: Dr. Goldstein has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Ashley Havlicak Lab Assistant, University of Utah, School of Medicine, Salt Lake City, Utah Faculty: Ms. Havlicak has indicated she has no financial relationships to disclose relevant to the content of the CME activity. C. Jeffrey Hoydu, MBA, RRT Director Respiratory Care Services, Primary Children's Hospital, Salt Lake City, Utah Faculty: Mr. Hoydu has indicated he has no financial relationships to disclose relevant to the content of the CME activity. Jon Mohammad Rostami Jam, MD, FAAP Assistant Professor of Pediatrics, Loma Linda University Health Care, Loma Linda, California Faculty: Dr. Jam has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Donald M. Null, Jr., MD Professor of Pediatrics, University of Utah Department of Pediatrics; Medical Director, Primary Children's Medical Center NICU, Intermountain Healthcare, Salt Lake City, Utah Course Director/Faculty/Planning Committee: Dr. Null has indicated that he has no financial relationships to disclose relevant to the content of the CME activity.

Kassidy Rinehart Undergraduate Researcher, Albertine Lab, University of Utah, School of Medicine, Salt Lake City, Utah Faculty: Ms. Rinehard has indicated that she has no financial relationships to disclose relevant to the content of the CME activity. Eveline Staub, MD Division of Neonatology Research Fellow, University of Utah, School of Medicine, Salt Lake City, Utah Faculty: Dr. Staub has indicated that she has no financial relationships to disclose relevant to the content of the CME activity. Daniel Tawfik, MD Division of Pediatric Critical Care, University of Utah School of Medicine, Salt Lake City, UT; Division of Respiratory Care Services, Intermountain Healthcare, Salt Lake City, UT Faculty: Dr. Tawfik has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Robert Ward, MD, FAAP, FCP Professor of Pediatrics, Attending Neonatologist, Adjunct Professor, Pharmacology/Toxicology, University of Utah School of Medicine, Salt Lake City, Utah Faculty: Dr. Ward has indicated that he has financial relationships with Astellas, Cadence, and Janssen Pharmaceuticals. Craig Wheeler, BS, RRT Level III Therapist, Boston Children's Hospital, Boston, Massachusetts Faculty: Mr. Wheeler has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Jeffrey W. Wright, BS, RT, RRT-NPS Respiratory Care Practitioner, Primary Children’s Medical Center, Intermountain Healthcare, Salt Lake City, Utah Faculty: Mr. Wright has indicated that he has no financial relationships to disclose relevant to the content of the CME activity. Bradley Yoder, MD Professor of Pediatrics, Division of Neonatology, University of Utah, Medical Director, University Hospital, Newborn ICU, Salt Lake City, Utah Faculty: Dr. Yoder has indicated he has financial relationships with Ikaria, Vapotherm, and Fisher & Paykel.

The following planning committee members and staff have indicated that they have no financial relationships to disclose relevant to the content of the CME activity: Kurt Albertine, PhD Marilyn Rigby, NNP Tracy Karp, NNP Carolyn Smith Keith Meredith, MD SarahAnn S. Whitbeck, MBA, CCMEP Arun K. Pramanik, MD Intermountain Healthcare Continuing Medical Education (CME) is accredited by the Accreditation Council of Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Intermountain Healthcare Continuing Medical Education Department designates this live activity for a maximum of 20.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This program has been approved for 20.74 contact hours Continuing Respiratory Care Education (CRCE) credits by the American Association for Respiratory Care. Intermountain Healthcare CME adheres to ACCME Standards regarding industry support of continuing medical education and disclosure of faculty and commercial sponsor relationships (if any) will be made known at the activity. Intermountain Healthcare CME fully complies with the legal requirements of the ADA and the rules and regulations thereof. If any participant of this program is in need of accommodation, please do not hesitate to call and/or write to the CME office in order to receive service. A request for accommodation can be made by calling 801.442.3930. Reasonable prior notice is required.

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