FOT (Forced Oscillation Technique)
FOT has been validated in comparison with other sophisticated methods, including CT Scan.
Because of its importance to the protection and preservation of lung architecture, strategies for optimizing lung volume are critical – especially in preterm newborns. Usually, CPAP, PEEP and MAP are adjusted according to oxygenation, both in conventional modes and during High-Frequency Oscillatory Ventilation (HFOV). But oxygen saturation (SpO2 or pO2) may be an imperfect guide for MAP or PEEP titration: there remains a risk that PEEP-induced over-distension and intra-tidal recruitment/derecruitment go unnoticed.
The patented Forced Oscillation Technique (FOT) is a non-invasive, protective and easy method that allows the clinician to assess an optimally recruited lung. During a recruitment manoeuvre FOT determines the optimal reactance Xrs by sending a small and well defined pressure oscillation into the airway opening, and subsequently measures the flow response of the respiratory system. The reactance Xrs is a very precise measure of how the lung reacts to the pressure pulse. By setting the optimal CPAP, PEEP and MAP level for the individual patient, FOT greatly reduces mechanical stress to the lungs, and brings down ventilation costs.
FOT allows the clinicians to assess the optimal mean airway pressure by measuring respiratory system reactance Xrs, and tailors protective HFOV or CMV ventilation support to the individual patient.
FOT minimizes gas trapping, overdistension, and atelectasis, leading to a more protective ventilation strategy compared to an oxygenation-based approach.
FOT measures Reactance Xrs accurately during HFOV and Conventional modes, without the need to disconnect the patient from the ventilator or connect expensive additional devices; it also significantly reduces the number of X-ray procedures required.
As a simple assisted procedure, FOT allows the clinician to easily adjust the pressure settings and therefore optimise workflows. FOT patients are well prepared for subsequent PRICO treatment (Predictive Intelligent Control of Oxygenation) and can usually be discharged earlier from NICU or PICU.
FOT was developed by Prof. Raffaele Dellacà and his team at Politecnico Milano, one of the most prestigious international medical engineering universities. The groundbreaking new technology has been validated in cooperation with top clinical NICU/ICU departments over a ten-year period.