Day 2 Main Conference Roundup

After a highly successful first day at the Fifth King’s John Price Paediatric Respiratory Conference - and enjoying a fifth birthday dinner at the Waldorf - delegates returned to Bush House on the morning of April 4th for the second main conference day. Following on from yesterday’s packed programme of keynote plenaries, concurrent sessions tailored to delegates interests and personal and professional sessions, Day 2 of the conference also offered delegates the opportunity to interact with the many fantastic posters of new research submitted by paediatric respiratory researchers worldwide.

Parallel Personal Practice Sessions

This morning’s personal practice sessions allowed delegates to choose one of three very different sessions. For those with an appetite for early morning statistics, a masterclass on lung function reports and consolidation of knowledge through case based discussions was a popular choice, while a professional development session sharing reflections on a career in medical education and service delivery alongside clinical work offered delegates the opportunity to explore career options with an experienced portfolio clinician. As part of the conference’s health and wellbeing strand, begun on day 1 with concurrent sessions on coaching and positive thinking for healthcare professionals, a final parallel practice session addressed the tricky topic of junior doctor burnout - presenting reasons and approaches to combating burnout through understanding the roots of the problem and practical advice.

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Keynote Plenary

Professor Stan Szefler joined us to expand upon conversations from day 1 on the use of technology in asthma care. He focused on using technology to close the communication gap between asthma practitioners, schools and parents of asthmatic children; highlighting his success with the use of an online school record communication system for improving outcomes by connecting the dots of all the environments in which an asthmatic child moves. He also discussed the importance of a yearly plan in school age children that robustly prepares them for the summer holidays, which is a risky time for asthma exacerbations. The vast amount of data produced and the need to develop machine learning and other artificial intelligence to extract meaningful data sets and conclusions from this ‘big data’ was also touched upon.

Following Prof Szefler, we heard from Professor Francine Ducharme on the risks and benefits of daily versus intermittent inhaled corticosteroids (ICS) in controlling preschool episodic wheeze. She first discussed the limitations of assessing the respiratory function of children between episodes of wheeze - asking if our detection level is low enough in preschool children, as clinicians rely on third party reporting to assess the ‘normality’ of a child’s breathing between episodes. Take home message: if there are exacerbations of wheeze but no symptoms between, treat with low dose ICS daily rather than a ‘rescue’ therapy of moderate or high dose ICS at onset of symptoms.

Concurrent Session: Asthma

With asthma mortality and morbidity in the UK lagging behind other developed countries, this indepth session took delegates through the ‘timeline’ of asthma, from the evidence for risk factors that can be modified in early life, to ensuring that the diagnosis of asthma is correct every time, to a comprehensive update on the latest developments in treatment strategies for asthmatic children. The three talks in the session all emphasised the need for a holistic approach at all stages as children move through asthma presentation, diagnosis and management; ensuring that clinical history and examination is used in conjunction with investigations, including exercise provocation, methylcholine challenges and oscillometry, in diagnosing children with asthma.

The longer talks were interspersed with poster presentations, including projects on an innovative school network for managing asthma at school; preventing admission to PICU in severe asthmatics; work from Hong Kong on the effectiveness of a smoking cessation programme in parents of children with chronic lung disease; and adrenal suppression in asthmatic children.

Concurrent Session: Cystic Fibrosis

Creative thinking in diagnosing and treating infections in patients with cystic fibrosis, as well as an update on emerging therapies, were discussed in this session aimed at clinicians with frequent contact with children with cystic fibrosis. The benefits of early diagnosis of cystic fibrosis through neonatal testing were outlined - not only on lung function, but in other, holistic areas, such as an early diagnosis increasing parental confidence in medical professionals; crucial in patients who will have multiple interactions with healthcare professionals in the course of their chronic disease. The role of air pollution in cystic fibrosis was explored, interestingly concluding that there is not a clear picture of the interaction between air pollution and poorer lung function and frequency of exacerbations in patients with cystic fibrosis.

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Concurrent Session: Other Respiratory Comments

This session covered a diverse selection of respiratory complaints that had not been fully covered elsewhere, including respiratory sequelae of obesity in children - with the revelation that if children with obstructive sleep apnoea (OSA) are non-compliant with nightly non-invasive ventilation, they should not be recommended for a provisional driving licence! Investigating and managing anatomical chest wall deformities, such as pectus excavatum and carinatum with a final talk covering the risks of air travel to children’s lungs - and if - and why - testing may be needed to avoid harm from air travel in certain demographics of paediatric patients, an extremely interesting perspective on the now-innocuous practice of travelling by plane.

Poster presentations in this session covered OSA as an independent risk factor for adult hypertension; the associations between nutrition and adverse respiratory outcomes in extremely premature infants; keeping wheezy children out of hospital where appropriate; and an exploration of subsequent respiratory exacerbations in children with post-infectious obliterative bronchiolitis.

Severe Asthma Symposium

Sponsored by GSK, one of the conference’s Gold level sponsors this year, this symposium of two speakers covered the evidence for emerging treatments in severe asthma, including use of biologics such as mepolizumab and omalizumab, with reflections on the evidence base and clinical experiences of successfully using these treatments in severe asthma.

Keynote Plenary: Respiratory Pearls

To round off a fantastic three days at the Fifth King’s John Price Paediatric Respiratory Conference four experienced paediatric respiratory clinicians were welcomed to the stage to share their experiences, insights and pearls of wisdom from their clinical lives. Professor Hans Bisgaard, lead of the extensive Copenhagen Studies on Asthma in Childhood in Denmark, opened with the provocative title of ‘From the Black Cobra Snake to the Salmon,’ a talk on the effect of the uterine and very early life environmental milieu on future risk of developing asthma and atopy, drawing on his experience with large longitudinal studies. By understanding these environmental risk factors, we can modify them - as Professor Bisgaard did in his work with supplementing pregnant mothers with fatty acids from fish oils.

Professor Steve Cunningham joined us from the University of Edinburgh to discuss RSV, including the efficacy of maternal vaccination for RSV and subsequent offspring RSV infection and severity of infection - vaccination reduces severity, but a recent large study failed to meet their primary outcome. Monoclonal antibodies have also been explored in treatment of RSV, with mixed results - difficulties include the natural history of the mutation of the RSV from season to season, and thus the pitfalls of targeting single epitopes on the RSV genome.

The pertinent topic of the effect of air pollution on paediatric respiratory disease, briefly covered earlier on in the day in one of the concurrent sessions was the focus of Professor Jonathan Grigg’s talk, who lamented the UK’s ability to measure - but not reduce - levels of air pollution. High levels of air pollution put children at risk of a reduction in lung function, development of asthma and worsening of underlying respiratory disease. Pollutants penetrate into the deepest realms of the lung, causing oxidative stress and being taken up by immune cells; even placental macrophages have been found with carbon particulates in situ.

Dr Mark Rosenthal had the considerable honor of closing the John Price Paediatric Respiratory Conference this year with his talk ‘30 Years in Paediatric Respiratory: Myths, Mistakes, Controversies and Dogma.’ Through his entertaining lecture he reflected upon the experiences he has had during his clinical practice and refuted many misconceptions in commonly held beliefs across the spectrum of paediatric respiratory disease.

Alongside the afternoon’s pearls of wisdom our winning poster abstracts were presented and discussed. Many of these abstracts were submitted by talented medical students and early career researchers, 25 of whom received bursaries to cover the cost of their attendance at the conference. All of the abstracts that were selected are available to read here: http://www.paediatricrespiratory.com/abstracts-2019

The conference closed with drinks with the fantastic view from the terrace of Bush House - still beautiful despite the inclement weather!

The conference organisers would like to thank their faculty, the team of student and junior doctor volunteers, and the catering staff who kept us fed and watered throughout the three days of the event. Most of all, they thank the delegates for giving up their valuable time for being with us and joining the conversation on how we can best serve our paediatric respiratory patients. Remember to fill in the feedback form on the conference app to receive your attendance certificate.

The conference organiser, Dr Atul Gupta, must be congratulated for organising and running such an ambitious programme with so many fantastic national and international speakers, and concurrent sessions to meet all interests. We look forward to seeing you again next year!

If you were unable to be with us this year, you can join the conversation on our Twitter feed @LondonPaedResp or by searching our conference hashtag ‘#paedresp2019.

Day 1 Main Conference Roundup

The Fifth King’s John Price Paediatric Respiratory Conference, having enjoyed an extremely well received day of pre-conference masterclasses and the ‘Science and Story’ themed Opening Ceremony on the 2nd April, opened the main conference programme on Wednesday 3rd April 2019 in the stunning setting of the newly renovated an opened Bush House. The programme was packed with all-delegate keynote plenaries, as well as smaller group concurrent sessions selected by delegates to align with their own personal interests. With a focus on collaborative discussion of the diagnosis and management of a diverse range of paediatric respiratory disorders, the conference welcomed over 300 delegates from across the spectrum of health and allied practitioners for a day of paediatric respiratory excellence.

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Parallel Personal Practice

For those delegates for whom a small group session over coffee and pastries appealed, a choice of five Personal Practice sessions were available for delegates to select to supplement their personal practice and goals. Some sessions focused on personal and professional development, with workshops on ‘Academic Survival,’ with practical pointers on writing academic CVs, grant applications and papers; and another on delivering effective presentations. Others allowed delegates to practice and develop their diagnostic and investigation skills with sessions on exercise testing and spirometry, whilst a final session gave delegates the chance to get hands on with allergy skin prick testing.

Keynote Plenary - State of Art

We were lucky enough to have some speakers from our ‘Science and Story’ Opening Ceremony joining us again today for the opening keynote lectures, with national and international faculty speaking at our opening keynote plenary, ‘State of Art,’ presenting the latest updates in asthma research from across the globe. Professor Andy Bush opened with his keynote ‘The Dead Canary:’ providing insight into the impact of early impaired lung function on all cause mortality, and highlighting the effect of in-utero nicotine exposure on the developing lung. Debate abounded in the discussion session - should we be funding research into the effect of maternal vaping on foetal lung development?

Professor Francine Ducharme, in her talk ‘Preschool Asthma,’ highlighted wheeze as symptom not as diagnosis, and emphasized that the same parameters needed to define asthma in preschoolers as is used elsewhere. Covering the latest evidence on the long term outcomes of treating preschool wheeze with a strong focus on evidence based interventions in preschool wheezers and their later life outcomes.

Professor Stan Szefler presented his research and experience into lung function trajectories and their use as a clinical and patient facing tool for assessing and altering the natural history of asthma and prevention of long term adverse outcomes. The role of the effective scoring - and communication of said scoring - of disease severity and use of evidence validated tools to score disease severity has been a cornerstone of Professor Szefler’s practice, and he encouraged delegates to take the same approach with their asthmatic patients. Should we be using technological innovations to monitor asthma adherence? Professor Szefler believes technology can be integrated into practice to better monitor medication adherence.

The conference concurrent session streams allowed delegates to select one of four smaller group concurrent sessions in both the morning and the afternoon to align with their personal interests. Each session shared research updates and practice guidance across combinations of lectures, open discussions, and activities on the session theme.

Concurrent Session: Asthma

Continuing the theme of asthma from the morning's keynote, this session invited delegates to consider dimensions in this common and often challenging to manage condition. Outdoor seasonal allergens and air pollution are often considered when coming up with asthma management plans - but what about the indoor environment? Attendees were taught about the importance of damp, moulds and other indoor allergens and how incorporating avoidance of these into asthma management plans can improve asthma control. The problems of maintaining asthma control during adolescence and key strategies for maintaining adequate control of asthma symptoms during this transitory time were discussed, as well as the evidence base for asthma education programmes and how these can be effectively utilised in practice.

Concurrent Session: Systemic Disorder in Development of Pulmonary Disease

This varied session covered diverse systemic diseases and their relation to and interaction with the development of pulmonary pathology. The lectures covered the management of wheeze in children with sickle cell disease; the diagnosis and management of ciliopathy syndromes through recognition of a common phenotype in children with the spectrum of ciliopathy syndromes; and the contribution of congenital heart disease to the pulmonary health of children with these heart conditions. These in-depth, specialist-driven lectures were of great use to attendees who encounter these paediatric patients in practice.

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Concurrent Session: Sleep

The talk on comprehensive management of disordered breathing in sleep in this concurrent session provided a holistic overview of how to investigate and treat children who have sleep disordered breathing; and non-respiratory disorders that result in excessive daytime sleepiness were explored to build delegates’ confidence in differentiating respiratory and non-respiratory causes of excessive sleepiness. An interesting session on sleep disordered breathing in children with craniofacial syndromes, covering the physiological and medical aspects of the condition.

Concurrent Session: Health and Wellness

It has been a topic of great discussion and debate over the last few years: how we can avoid burnout, mental health issues and substance misuse problems in doctors, who often lead challenging lifestyles that make them unable to dedicate time to looking after themselves. This workshop was designed by dually qualified physicians and life coaches to teach attendees some simple, accessible skills from coaching that can be employed in their day to day lives in order to attempt to manage burnout and ‘remain resourceful.’ The session emphasised that investing in coaching and coaching skills is not a remedial action, but could allow clinicians to maintain their levels of resourcefulness and prevent burnout before it starts.

Delegates had ample opportunity over a fantastic lunch provided by King’s Food to network with one another, to engage in further discussion with present faculty, and talk to our exhibitors, who included companies providing innovative pharmaceutical and technological solutions for respiratory pathologies.

Delegates had ample opportunity over a fantastic lunch provided by King’s Food to network with one another, to engage in further discussion with present faculty, and talk to our exhibitors, who included companies providing innovative pharmaceutical and technological solutions for respiratory pathologies.

Concurrent Session: Pearls

These ‘pearls of wisdom’ included an overview of habit cough, highlighting the value of a thorough history in diagnosis - which does not always have to be a diagnosis of exclusion - and reassuring parents when a diagnosis of habit cough is made, as well as discussing the long term sequelae of tic and other behavioural disorders in children who present with habit cough. In ‘What Kind Of Asthma Do I Have,’ the psychosomatic component of asthma and harnessing the proven benefits of placebo alongside traditional asthma treatment was explored. Mutual learning and the benefits of Western medical systems learning from resource poorer countries was a thoughtful end to the session, including learning from the efficiency and cost-effectiveness of telemedicine for treating rural or low resource populations, such as in India.

Concurrent Session: Sleep/NIV

A further session on sleep and non-invasive ventilation allowed delegates a second opportunity to learn about paediatric sleep disorders and the use of non-invasive ventilation, which is increasingly chosen over more invasive methods in neonates and the acutely ill child. The first talk covered the indication for and use of NIV in acute situations; including when to choose NIV over more invasive methods. A second session on the neurocognitive consequences of childhood obstructive sleep apnoea outlined the growing evidence base for neurological, cognitive and behavioural sequelae in children with poorly managed obstructive sleep apnoea.

Concurrent Session: Allergy

This broad ranging session, with talks on rhinitis and sinusitis, food allergies and eczema - thus giving an overview of the atopic triad - examined the use of local allergen testing in skin prick negative children with allergic symptoms, and the impact of allergic rhinitis on sleep, concentration and school outcomes. Updates on the early diagnosis and management of food allergies and upcoming treatments in eczema completed the atopic triad update, equipping attendees with the most up to date evidence base in order to equip them with the knowledge they need to provide their patients with gold standard care.

Concurrent Session: Positivity in Practice

This holistic practice-based session led by a specialist social worker introduced attendees to the benefits of using active positive thinking in practice in order to protect practitioners against the pitfalls of burnout and mental illness. This active workshop went hand in hand with the morning’s Health and Wellness session to provide a theme through the conference of protecting the wellbeing of practitioner as well as patient.

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Keynote Plenary

Our closing plenary talks reflected the opening talks in that they welcomed a diverse range of clinicians, both in discipline and geography. Professor Felix Ratjen joined the conversation from SickKids Toronto, elaborating on his experiences monitoring and managing early lung disease in children with cystic fibrosis, highlighting the use of multiple breath nitrogen washout as a standard monitoring investigation and the advantages and disadvantages of MRI in monitoring disease.

Professor Leila Kheirandish-Gozal’s plenary on adenotonsillectomy - a procedure that has waxed and waned in popularity over the last fifty years - presented work on the contribution of adenotonsillar hypertrophy on obstructive sleep apnoea; a condition that affects 3/10 children. Professor Kheirandish-Gozal emphasised the importance of viewing children with OSA holistically, taking the history and examination in conjunction with hypoxia indices and sometimes sleep studies; particularly as her work has shown that many children have residual OSA after adenotonsillectomy, impacting on the decision to take a child to theatre. She also spoke on her experiences with successfully managing OSA with either oral, nasal, or a combination of anti-inflammatories.

Professor Paul Brand joined us from the Netherlands to discuss adherence in chronic lung conditions, sharing the statistic that just 50% of medication prescribed for children with asthma is actually used - with education strategies making no difference. So how can clinicians help their patients to adhere to the gold standard treatments? Professor Brand suggests unpicking and understanding parental beliefs around administering medication and listening to their concerns ‘with the intent to understand.’

Closing Discussion

Our closing discussion of the day, chaired by Dr Will Carroll and with the expertise of Professor Antonio Nieto, was a conversation surrounding the latest evidence in long term outcomes in paediatric severe asthma, and what clinicians treating children with severe asthma can expect - and the best outcomes to aim for - in terms of morbidity as these children transition into adulthood and adolescence.

Those who wished then joined the conference committee in the evening to enjoy a celebratory fifth anniversary dinner.

Day 1 of the conference has showcased the diversity of paediatric respiratory practice as a specialty, as well as generating some lively group discussion, both in person and across social media. The conference organisers look forward to welcoming delegates back tomorrow to continue to provide updates, practice pearls and wisdom to our valued delegates.

Thank you to our speakers and session leaders for joining us today for our fifth annual conference, and to our delegates for giving up your valuable time to contribute your thoughtful insights. We look forward to even more discussion on Day 2.

For the highlights of the pre-conference masterclasses and the Opening Ceremony, see our Day 1 Highlights Blog. If you weren’t able to be at the conference this year, insights can be found on our Twitter feed @LondonPaedResp or by searching this year’s conference hashtag ‘#paedresp2019’.

Pre-Conference Masterclasses: A Summary

The Fifth King’s John Price Paediatric Respiratory Conference kicked off this year with ten whole-day, hands-on pre-conference masterclasses, covering fundamentals, innovations and practical aspects of a diverse range of paediatric respiratory problems.

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Psychosocial Workshop in Paediatric Respiratory Care

This workshop aimed to inform delegates of the psychosocial constellations of problems surrounding children with chronic respiratory disease, focusing particularly on difficult asthma and its psychosocial associations. Delivered by healthcare professionals from the Royal Brompton, KCH and Great Ormond Street, it also covered strategies to prevent procedural anxiety from developing, and managing it when it does occur. The masterclass highlighted the social factors that can contribute to difficult to manage asthma, and how these factors can be identified and effectively managed to improve outcomes. Useful discussion to come from the masterclass included practical approaches and innovations that can support the resilience and coping of families with children with chronic respiratory disorders, as well as supporting clinicians in their own resilience.

Paediatric/Young Adult Asthma Training

This masterclass, focusing sharply on how paediatricians and allied healthcare professions can prevent unnecessary asthma deaths, covered the timeline of child presenting with symptoms of asthma - such as wheeze - through diagnosis, enabling effective adherence to medication and other management, through to monitoring and individualising asthma care. With interactive case discussions and a closing quiz, this workshop presented the most recent research insights into risk factors for asthma deaths, as well as practical approaches to improving adherence and approaching the child with severe or refractory asthma. By combining an evidence based approach with practical pearls from clinicians experienced in asthma care, this masterclass provided participants with the tools they need to have confidence in being an Asthma Champion in their faculty.

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Paediatric Sleep

The Paediatric Sleep masterclass, presented by senior sleep doctors and specialist sleep physiologists, provided a crash course in the range of sleep investigations available in the UK, when they should be used, and the interpretation of the resulting studies. With practical interludes demonstrating the set up of monitoring equipment on a volunteer, this masterclass combined in-depth lectures and discussion with hands-on sessions culminating in sleep investigation interpretation quizzes to consolidate the learning of the day.

Thoracic Ultrasound and Guided Drain Insertion

This highly practical masterclass focused on equipping delegates with the theoretical and practical skills needed to be confident in the use of thoracic ultrasound for viewing pleural, pulmonary, diaphragmatic, thymic and laryngeal pathology, and using ultrasound guided techniques for managing some of these pathologies. Delegates had the opportunity to rotate around three practical sessions, including diagnostic ultrasound; practice of ultrasound-guided needle placement for pleural drain insertion; and practice of intercostal anaesthetic blocks for pleural intervention. These practical techniques were underpinned by lectures on the physics of ultrasound and normal anatomy on ultrasound to provide delegates with a clear underpinning of the theory behind the techniques.

Paediatric Dysfunctional Breathing: Diagnosis to Discharge

Designed to ‘provide better understanding of dysfunctional breathing in children from diagnosis to discharge,’ this masterclass covered the investigation, diagnosis and management of dysfunctional breathing, beginning with the warning that ‘not all dyspnoea is asthma.’ Practical rotations in the afternoon covered the techniques used by and impact of physiotherapists and speech and language therapists involvement in the care of children with dysfunctional breathing, allowing medical colleagues an insight into the tools used by different members of the MDT. Interactive cases allowed for application of the theories and skills learnt to real life case discussions.

Interpreting Oximetry in Children: Controversies and Consensus - New Dimensions to Explore

This session explored the wide scope of use of oximetry in paediatric respiratory patients, from its use in neonates admitted to the NICU to use in older children referred for obstructive sleep apnoea. With a particular focus on the evidence base for the various uses of oximetry, the masterclass allowed delegates to get to grips with interpreting oximetry traces whilst being mindful of the clinical context. A parent’s perspective was also discussed as the workshop welcomed the parents of a paediatric patient who required oxygen at home to share their experiences of the home oxygen service. Practical sessions provided tips on setting up oximeters and getting the most out of interpretation software.

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Measuring Spirometry in Children

Tackling the nuances of interpreting spirometry traces in paediatric patients, the masterclass, led by paediatric respiratory physiologists, recapped some basic respiratory physiology before allowing delegates a hands on session in setting up spirometry equipment. The basics covered, the remainder of the workshop focused on the use and interpretation of spirograms, including detecting errors, when to use bronchodilators, and recognition of obstructive and restrictive patterns of spirometry. The session rounded off with group discussion and interpretation of cases, embedding the learning of the day into clinical scenarios.

Acute NIV

With an increasing shift in use of non-invasive ventilation over intubation in the context of acutely unwell children, this masterclass equipped delegates with the theoretical and practical knowledge to recognise when NIV is an appropriate choice; use NIV safely and effectively; and manage some of the challenges of NIV. Multiple small group skill stations gave every delegate the chance to practice common scenarios in which NIV should be used, in both children and infants, with full simulation of selection of equipment, settings and appropriate monitoring.

Stabilisation of the Acutely Unwell Child

In this much sought after session delegates were taken through the management of the critically unwell child, from rapid assessment to a structured approach to management to referral on to high dependency or intensive care units. With a focus on acute respiratory presentations such as bronchiolitis, acute asthma, pneumonia and empyema, discussion sessions included airway management and use of nebulised hypertonic saline. A masterclass that drew upon the expertise of emergency, paediatric and anaesthetic colleagues, the highlight was the high fidelity simulation of a case of an acutely unwell child that closed the day.

The Chronic Lung Disease of Prematurity Masterclass Team

The Chronic Lung Disease of Prematurity Masterclass Team

Chronic Lung Disease of Prematurity - Challenges Today and Tomorrow

Welcoming respiratory and neonatal specialists alike, this masterclass aimed to cover the prevention and management of bronchopulmonary dysplasia, with a focus on comparing the evidence for various prevention and management strategies. Further sessions explored the long term sequelae of bronchopulmonary dysplasia, including the latest updates in the neurodevelopmental outcomes and additional nutritional needs of children with bronchopulmonary dysplasia. Final words added a different perspective - that of the ethical challenges of having difficult conversations with parents, and how to effectively manage their expectations.

Thanks must go to all of our masterclass leaders, who generously gave their time, experience and insights to lead these interesting and thoughtfully delivered practical sessions.

For the highlights of the day, including of the Opening Ceremony, see our Day 1 Highlights Blog. If you weren’t able to be at the conference this year, insights can be found on our Twitter feed @LondonPaedResp or by searching this year’s conference hashtag ‘#paedresp2019’.

Pre-Conference Masterclasses & Opening Ceremony - Highlights Day 1

The Fifth King’s John Price Paediatric Respiratory Conference was delighted to open on Tuesday 2nd April with ten whole-day hands-on pre-conference masterclasses, as well as celebrating the fifth year of the conference with an Opening Ceremony and welcome drinks. Set in the resplendent backdrop of Bush House, formerly the home of the BBC World Service, and opened two weeks ago by the Queen and the Duchess of Cambridge as part of the King’s College London Strand Campus development, the pre-conference masterclasses welcomed delegates to enjoy small group sessions of their choice. Masterclasses included:

  • Psychosocial Workshop in Paediatric Respiratory Care

  • Paediatric/Young Adult Asthma Training

  • Paediatric Sleep

  • Thoracic Ultrasound and Guided Drain Insertion

  • Paediatric Dysfunctional Breathing: Diagnosis to Discharge

  • Interpreting Oximetry in Children: Controversies and Consensus - New Dimensions to Explore

  • Measuring Spirometry in Children

  • Acute NIV

  • Stabilisation of the Acutely Unwell Child

  • Chronic Lung Disease of Prematurity - Challenges Today and Tomorrow

Paediatric Respiratory Conference - Photo 1

The masterclasses were run by experts from all walks of healthcare; from doctors and nurses to specialist physiotherapists, social workers and radiographers, facilitating an atmosphere of cross-competency learning throughout the day. For a summary of the learning from the masterclasses, click here.

Delegates also had ample time to mingle and network with one another and with the conference exhibitors, and to share their insights throughout the day on social media, including Twitter and the specialist conference app.

Delegates were impressed by the informal nature of the workshops, which facilitated real group discussion and feedback, as well as the many practical sessions across the masterclasses - from stabilisation of the unwell child simulation to ultrasound guided chest drain insertion to interactive cases and quizzes. The benefit of the small masterclass sizes lies in the ability of the group leaders to really engage with delegates in a way that is rarely possible in large lecture theatres. The conference team are grateful to each and every one of the professionals who came to share their time and expertise in our well-crafted masterclass programme today.

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At the end of the day, the delegates came back together to celebrate the Opening Ceremony of the main conference. Welcome drinks were served alongside five talks from faculty joining us from across the globe. This year, the Opening Ceremony was themed ‘Science and Story,’ and provided speakers with the opportunity to explore their medical storytelling in order to consolidate knowledge and educate. Delegates were introduced to the neuropsychiatric effects of montelukast treatment; how to build bridges in asthma care to facilitate the best co-operation between clinician, family and patient possible; and about the disappearance of the headbox! A poignant talk on the importance of recognising and apologising for mistakes when they are made was greatly appreciated by many delegates.

Paediatric Respiratory Conference - Photo 3

The day rounded off with an informal poster walk where delegates had the opportunity to take in the fantastic posters that were submitted by those working in paediatric respiratory care from across the country - and, indeed, the world! 20 of these posters submitted by medical students or early career researchers have been awarded conference prizes.

The pre-conference masterclasses and Opening Ceremony have been a fantastic way to kick off the Fifth King’s John Price Paediatric Respiratory Conference, and the team is looking forward to welcoming more delegates tomorrow for our main programme.

For those who were unable to join us today, there is a wealth of social media updates available on our Twitter page @LondonPaedResp or by searching for our conference hashtag ‘#paedresp2019’.


The International Speakers of the 5th Annual King’s John Price Paediatric Respiratory Conference

2nd-4th April 2019, Bush House

On behalf of the organising committee, it is my pleasure to welcome you to the 5th King’s John Price Paediatric Respiratory Conference.

The organising committee are delighted that this, the 5th year of the hugely successful Paediatric Respiratory Conference, plays host to a huge number of diverse speakers. In particular, we are grateful to those speakers who have given up their time to travel from overseas in order to enlighten and, hopefully, entertain our attendees with their insights and anecdotes on their years working in paediatric respiratory medicine. This year, we welcome speakers from as far afield as the USA; Canada; the Netherlands; India and Spain. We are excited to introduce our international speakers, their backgrounds and achievements. The organisers hope you are looking forward to hearing from them as much as we are!


Professor Stan Szefler

Professor Szefler has dedicated his clinical and research career to his passion of appropriate use of long term asthma treatment, and the variability of responses to long term asthma treatment.

Professor Szefler’s achievements within the profession have been numerous; he is currently Director of the Paediatric Asthma Research Program at the Breathing Institute of the Paediatric Pulmonary Section at Children’s Hospital Colorado, as well as teaching in his role as Professor of Paediatrics at the University of Colorado. His has formerly been a member of illustrious panels, including that of a National Asthma Education and Prevention Programme; and continues to serve as Deputy Editor of the Journal of Allergy and Clinical Immunology.

At the 5th Paediatric Respiratory Conference, Professor Szefler joins us at our Opening Ceremony on narratives and storytelling in medicine with a talk entitled ‘Building Bridges to Improve Asthma Care?’ We are also delighted to welcome Professor Szefler to our main programme, where he will be speaking on the risks associated with a lifetime managing asthma; and advances in technology in asthma care.


Professor Francine M Ducharme

Professor Ducharme’s research interests lie in improving paediatric asthma morbidity through a range of interventions, including education, policy and therapeutics.

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Professor Ducharme has held many positions of distinction through her career; currently she serves as Associate Director of Clinical Research and Knowledge Translation at the Centre Hospitalier Universitaire Sainte-Justine, as well as co-chair of the Asthma Assembly of the Canadian Thoracic Society, who oversee the writing and updating of asthma guidelines used across Canada. She is paediatric editor of the Cochrane Airways Review, and has been since its foundation in 1995.

For the 5th Paediatric Respiratory Conference, Professor Ducharme takes us through preschool asthma, discussing the diagnosis, management and prognosis of those with symptoms of asthma before the age of five, as well as a second session covering inhaled corticosteroid treatment. She also joins us for our Opening Ceremony with a talk on the neuropsychiatric impact of montelukast treatment, which promises to give a fascinating insight into some of the perhaps lesser-known effects of asthma treatment.


Professor Leila Kheirandish-Gozal

Professor Kheirandish-Gozal’s expertise lies in paediatric sleep medicine, and she is considered one of the global leaders of the field. Her research focuses on children with obstructive sleep apnoea and their cognitive outcomes.

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Professor Kheirandish-Gozal is Director of the Child Health Research Institute at The University of Missouri, Colombia, as well as serving on the editorial boards of several publications, including the American Journal of Respiratory and Critical Care Medicine. She has received a Presidential Commendation from the American Thoracic Society for her contributions; and was awarded an Order of Extraordinary Merit from the Peruvian Medical Association for work she has done on sleep in high-altitude Inca populations.

In 2019, we are lucky enough to have Professor Kheirandish-Gozal joining us for the keynote & concurrent sessions, where she will be sharing her considerable expertise on the neurocognitive impact of obstructive sleep apnoea; and the risk-benefit analysis of adenotonsillectomy.


Professor Hans Bisgaard

Professor Bisgaard works in large cohort studies to investigate the origins of asthma and other allergic disease.

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He has recently been working on the large Copenhagen Prospective Study on Asthma in Childhood, which recruited more than 1100 women and their children. Professor Bisgaard is a Professor of Paediatrics at the University of Copenhagen and has published tens of articles in various journals across his career.

Professor Bisgaard joins us in our final session of the conference this year to share some pearls of wisdom from his time working in paediatric respiratory care.


Professor Paul Brand

Professor Paul Brand’s interests lie in adherence to asthma treatment and management of food allergies.

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He is Dean of Medical Education at the Princess Amalia Children’s Centre of Isala Hospital, one of the largest teaching hospitals in the Netherlands; he also serves as honorary professor of Clinical Medical Education at the University Medical Centre in the Netherlands. He has published over 200 papers in various national and international journals, as well as two novels! He has also worked extensively in teaching, including research into medical education.

Professor Brand joins us this year for our Opening Ceremony of the 5th Paediatric Respiratory Conference; sharing with us as part of our ‘Science and Story’ theme a talk entitled ‘Sorry Seems To Be The Hardest Word.’ We are pleased to also welcome him to our main programme for two talks that represent his two areas of interest; one on the doctor’s role in improving adherence, and another on how we can address the current epidemic of junior doctor burnout.


Professor Felix Ratjen

Professor Felix Ratjen’s particular interest is in paediatric cystic fibrosis.

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He is Division Chief of Paediatric Respiratory Medicine at The Hospital for Sick Children, Professor of Paediatrics at The University of Toronto, and Senior Scientist at the Research Institute in the Translational Medicine research program. As part of his work at Toronto SickKids, he leads the centre for cystic fibrosis, as well as directing the Clinical Research Unit. Professor Ratjen has previously led the German cystic fibrosis foundation; and serves on the editorial boards of several journals, including the esteemed American Journal of Respiratory and Critical Care Medicine.

Professor Ratjen joins us for two sessions at the 5th Paediatric Respiratory Conference, updating delegates on the tracking of early lung disease and sharing his knowledge of emerging therapies for cystic fibrosis.


Professor Marti Pons Odena

Professor Marti Pons Odena has spent his career honing his knowledge and producing research on respiratory care for critical care paediatric patients, including neonates. His particular area of interest is in mechanical and non-invasive ventilation of paediatric patients.

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Professor Pons Odena serves on the board of national and international respiratory groups, including the Respiratory working group of the European Society of Paediatric Neonatal Intensive Care and Respiratory working group of the Spanish Society of Paediatric Intensive Care Specialists. He has travelled the world for speaking engagements, with his lectures featuring at multiple Paediatric Intensive Care World Congresses.

This year, he brings to the 2019 5th Paediatric Respiratory Conference his vast experience in paediatric intensive care to lecture on cutting edge techniques and technologies in non-invasive ventilation.


Professor Antonio-Nieto Garcia

Professor Antonio-Nieto Garcia joins us from Valencia, where he has worked for many years in paediatric respiratory care and allergy.

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Professor Garcia is currently serving as Head of the Pulmonology & Pediatric Allergy Unit in the Children’s Hospital La Fe of Valencia, as well as being the first Vice President of the Asociación Española de Pediatría. Professor Garcia has published extremely extensively in both international and national journals of his home country of Spain.

This year at the 5th Paediatric Respiratory Conference, we are lucky enough to have Professor Garcia joining us to update delegates on what should be expected of the long term outcomes in children with severe asthma.


Professor Paolo Pianosi

Professor Paolo Pianosi’s career in paediatric respiratory medicine has led to him developing a keen interest in the use of exercise testing in paediatric practice, most recently in adolescents suffering from dyspnoea in postural orthostatic tachycardia syndrome.

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Professor Pianosi has published his research in esteemed national and international journals, and has also contributed to textbooks dedicated to exercise testing. He is a full Professor of Paediatric and Adolescent Medicine at the University of Minnesota.

Professor Pianosi joins us at the 5th Paediatric Respiratory Conference for the third year in a row running his highly successful pre-conference masterclass in Paediatric Dysfunctional Breathing, as well as joining the main conference programme for a talk entitled ‘Getting the diagnosis of asthma right from the start.’


Professor Meenu Singh

Professor Meenu Singh has had a long and fruitful career in paediatric respiratory practice and research, with her particular interests lying in the areas of asthma, TB and cystic fibrosis.

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Professor Singh is Head of Pediatric Pulmonology at the Postgraduate Institute of Medical Education and Research, Chandigarh (PGIMER), and has worked extensively on projects that have become standard policy for healthcare in India, including the development of treatment guidelines for children with TB. She is currently working on a project on Allergic Bronchopulmonary Aspergillosis. Professor Singh also boasts achievements in medical education, having supervised many postgraduate students personally as well as serving as head of the telemedicine centre at PGIMER, leading the development of a broad tele-education network of universities across the country.

This year, we are delighted that Professor Singh joins us at the 5th Paediatric Respiratory Conference to share her experiences of practicing paediatric medicine in India, and what Western medical systems can learn from more resource challenged areas of the world.


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