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.’