The First Multidisciplinary Neuropulmonary Conference
...took place in the Dan Hotel in Tel-Aviv, on 06.05.2015.
The aim of the conference was to bring together for the first time neurologists, pulmonologists, ICU and rehab physicians to improve patient care- from the early stages of diagnosis to the long term management.
Dr. Ilana Schlesinger from the department of neurology at Rambam medical center opened the conference saying that the care of patients with neuromuscular disease and respiratory involvement is many times hectic and falls between the cracks.
Dr. Roni Eichel from the Hadassah medical center gave an excellent overview of the difficulties encountered in the diagnosis and management from the neurologists point of view.
Dr. Daniel Starobin from Kaplan medical center gave a comprehensive pulmonologist's review of diagnostic modalities available for diagnosis and follow-up of respiratory muscle involvement- going from standard spirometry to sophisticated direct measurement of respiratory muscle forces. He also discussed the strengths and limitations of the various tests.
Dr John Bach, from the center for non-invasive mechanical ventilation, Rutgers, New Jersey, USA, a pioneer in the field of non-invasive ventilation (NIV) discussed his vast experience with long term NIV in various neuromuscular diseases. He showed that even patients with near paralysis of the respiratory muscles can be supported with NIV for many years, as long as they have patent airways.
Prof. David Linton, the former head of the medical ICU in Hadassah, shared his knowledge and experience with the management of such patients in the acute care setting, whereas Dr. Alex Guber from Meir medical center provided the tools for the long term ventilatory care. Both stressed the utilization of NIV to avoid intubation and tracheostomies.
Dr. Michal Haran, a hematologist, shared her personal experience of living with a rare form of myasthenia.
Dr. Iuly Treger from Soroka medical center added the point of view of the rehab physician, pointing out that respiratory support is only one (even if an essential) component in the overall care, functional ability and quality of life of the patient.
Dr. Eliezer Beeri from Alyn discussed the model of care in pediatric patients, which is much more comprehensive. He too stressed the improvement in quality of life with NIV compared to invasive ventilation.
A round table discussion concentrated on the importance of finding optimal ways to monitor progression or response to treatment and on optimizing NIV support, given the growing technological options. Dr. Arie Wolner from Sheba medical center stressed the importance of recognizing respiratory impairment in the early stages, when it is mostly nocturnal and can easily be overlooked.
The therapy of neuromuscular diseases depends on the specific pathology. NIV is probably effective in the vast majority of the patients developing respiratory failure due to such diseases.
It is likely that early recognition of respiratory involvement and starting NIV can lead to better long term outcome. This can only be achieved by the combined efforts of all medical professionals involved in the treatment.
The second neuropulmonary conference