American College of Clinical Pharmacy
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Clinical Reasoning Series in Critical Care Pharmacy-- Management of Patients with Acute Respiratory Distress Syndrome

Monday, October 09, 2017 from 8:30 AM to 5:00 PM MST at Phoenix Convention Center North Building Street Level: Meeting Room 126

Available for 6.00 hours of CPE credit
Activity Number: 0217-0000-17-163-L01-P
Activity Type: An Application-Based Activity

Clinical Reasoning Series in Critical Care Pharmacy has been approved by the Board of Pharmacy Specialties (BPS) for the recertification of Board Certified Pharmacotherapy Specialists (BCPSs) and for the recertification of Board Certified Critical Care Pharmacists (BCCCP). Given the need for rapid decision-making regarding treatment of patients with acute respiratory distress syndrome, the complexity of treating these patients, and the evolving literature regarding management, this program will cover the most recent treatment strategies and summarize their place in the contemporary treatment of patients with severe respiratory failure.

Learning Objectives
1. Describe the epidemiology and pathophysiology of acute respiratory distress syndrome (ARDS).
2. Discuss diagnosis, etiology and overall treatment goals in the management of patients with ARDS.
3. Critically appraise the published literature surrounding the management of ARDS including ventilator and fluid management and use of neuromuscular blocking agents and prone positioning.
4. Select appropriate salvage therapies including the use of corticosteroids, inhaled vasodilators, and extracorporeal membrane oxygenation in patients with severe ARDS.
5. Design treatment regimens that optimize patient outcomes.
Introduction
8:30 AM to 8:45 AM

Speakers
  • Amy L. Dzierba, Pharm.D., FCCM, BCPS, BCCCPModerator: Amy L. Dzierba, Pharm.D., FCCM, BCPS, BCCCP
    Clinical Specialist, Critical Care Program Director, Critical Care Residency Department of Pharmacy, New York Presbyterian Hospital, New York, New York
      View Biography

Overview of Epidemiology and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
8:45 AM to 9:15 AM

Speakers
  • Mitchell S. Buckley, Pharm.D., FCCP, FCCMFaculty: Mitchell S. Buckley, Pharm.D., FCCP, FCCM
    Clinical Pharmacy Specialist – Medical ICU, Director of PGY1 Pharmacy Residency, Banner University Medical Center Phoenix, Phoenix, Arizona
      View Biography


Learning Objectives
1. Describe the incidence and mortality rates associate with ARDS.
2. Examine the attributed causes of death in ARDS patients.
3. Explain the pathogenesis and various phases of ARDS progression.
Diagnosis, Etiology, and Treatment Goals of ARDS
9:15 AM to 9:45 AM

Speakers
  • Jeffrey P. Gonzales, Pharm.D., BCPS, BCCCPFaculty: Jeffrey P. Gonzales, Pharm.D., BCPS, BCCCP
    Associate Professor, University of Maryland School of Pharmacy, Baltimore, Maryland
      View Biography


Learning Objectives
1. Compare and contrast the past and current definitions of acute respiratory distress syndrome (ARDS).
2. Identify common etiologies of ARDS.
Break
9:45 AM to 10:00 AM
Ventilator Management: Standard and Alternative Strategies
10:00 AM to 10:30 AM

Speakers
  • Faculty: Justin Muir, Pharm.D.
    Clinical Pharmacy Manager, Medical Intensive Care Unit, New York-Presbyterian Hospital, New York, New York
      View Biography


Learning Objectives
1. Describe usual ventilator settings in acute respiratory distress syndrome (ARDS) and therapeutic and safety targets related to mechanical ventilation.
2. Design plans for ventilator adjustments according to arterial blood gas results.
3. Summarize alternative ventilator modes for ARDS and the potential pros and cons of each
Therapies That Have Been Tried and Failed
10:30 AM to 11:00 AM

Speakers
  • Faculty: Jeffrey P. Gonzales, Pharm.D., BCPS, BCCCP
    Associate Professor, University of Maryland School of Pharmacy, Baltimore, Maryland
      View Biography


Learning Objectives
1. Critique acute respiratory distress syndrome (ARDS) studies that have failed to show benefit.
2. Identify characteristics of ARDS studies that may limit the ability to find a difference in interventions.
3. Illustrate research methodology that influences the ability to find a difference in interventions.
Fluid Management
11:00 AM to 11:30 AM

Speakers
  • Faculty: Jeffrey P. Gonzales, Pharm.D., BCPS, BCCCP
    Associate Professor, University of Maryland School of Pharmacy, Baltimore, Maryland
      View Biography


Learning Objectives
1. Demonstrate the importance of fluid and fluid balance in patients with acute respiratory distress syndrome (ARDS).
2. Critique FACTT and FACTT Lite studies.
3. Develop an algorithm to manage fluid in patients with ARDS.
Lunch
11:30 AM to 1:00 PM
Use of Prone Positioning and Neuromuscular Blocking Agents for ARDS
1:00 PM to 2:30 PM

Speakers
  • Faculty: Mitchell S. Buckley, Pharm.D., FCCP, FCCM
    Clinical Pharmacy Specialist – Medical ICU, Director of PGY1 Pharmacy Residency, Banner University Medical Center Phoenix, Phoenix, Arizona
      View Biography


Learning Objectives
1. Review the proposed beneficial effects for prone position and neuromuscular blocking agents (NMBAs) in acute respiratory distress syndrome (ARDS).
2. Evaluate the published clinical data for prone positioning and NMBA on outcomes in ARDS.
3. Recommend an evidence-based strategy for prone positioning and NMBA use in ARDS.
Break
2:30 PM to 2:45 PM
Salvage Therapies Employed for Severe ARDS
2:45 PM to 4:15 PM

Speakers
  • Faculty: Justin Muir, Pharm.D.
    Clinical Pharmacy Manager, Medical Intensive Care Unit, New York-Presbyterian Hospital, New York, New York
      View Biography


Learning Objectives
1. Demonstrate an understanding of the potential benefits and harms of inhaled pulmonary vasodilators in the management of acute respiratory distress syndrome (ARDS).
2. Critique the literature on the use of corticosteroids in the management of early and late ARDS.
3. Describe the place in therapy of extracorporeal membrane oxygenation (ECMO) in the management of severe ARDS.
4. Design pharmacotherapy regimens for patients receiving ECMO for ARDS.
5. Develop a systematic approach for using salvage therapies for severe, refractory ARDS.
Long-term Outcomes of Survivors
4:15 PM to 4:45 PM

Speakers
  • Faculty: Jeffrey P. Gonzales, Pharm.D., BCPS, BCCCP
    Associate Professor, University of Maryland School of Pharmacy, Baltimore, Maryland
      View Biography


Learning Objectives
1. Summarize long-term outcomes in ARDS survivors.
2. Discuss ARDS and precision medicine.
Closing Remarks
4:45 PM to 5:00 PM

Speakers
  • Faculty: Amy L. Dzierba, Pharm.D., FCCM, BCPS, BCCCP
    Clinical Specialist, Critical Care Program Director, Critical Care Residency Department of Pharmacy, New York Presbyterian Hospital, New York, New York
      View Biography