FORCED OSCILLATION TECHNIQUE (FOT) – A NOVEL METHOD FOR THE DETECTION OF EARLY AIRWAY CHANGES

Plamena Stoimenova, S. Mandadzhieva, Blagoi Marinov
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Abstract

According to the World Health Organization in 2019 chronic obstructive pulmonary disease (COPD) was the third leading cause of death worldwide, causing more than 3 million deaths whereas bronchial asthma affected more than 250 million people and caused 455 000 deaths. Both diseases are chronic obstructive conditions which need to be diagnosed early in order to prevent or slow down the complications. Consequently the world requires new effortless methods for diagnosis of airway obstructions, especially for small children and people who cannot perform the spirometry maneuver. The purpose of this report is to describe the objectives of the forced oscillation technique (FOT) and to establish its applications in the clinical practice. Studies and clinical cases regarding pulmonary function testing are summarized and analyzed. They are found in the following databases - PubMed, Google Scholar and Science Direct. Spirometry is the ‘gold standard’ for the diagnosis of airflow obstruction but it requires effort and can be difficult for patients to perform. Forced oscillation technique (FOT) on the other hand is a relatively new method that may hold the key to identifying smoking-related respiratory early alterations and childhood asthma. FOT requires tidal breathing while applying external, small amplitude oscillations in order to determine the response of the respiratory system. Therefore, it is easy for pre-school children to perform. The benefit of FOT should be taken into account for patients who cannot perform spirometry or other pulmonary function ttests. The minimal cooperation of the patient and the easy tidal breathing maneuvers make this method a great option for every pulmonologist. Compared to spirometry this technique may be more sensitive in the detection of disturbances of the peripheral airways and may be effective for the control of therapy at a long term. The Forced oscillation technique has been successfully applied in many pediatric respiratory disorders, such as asthma, cystic fibrosis, and chronic lung disease. Considering these qualities FOT may be used as an alternative of spirometry in heterogenous ventilatory disturbances of the small airways.
强迫振荡技术(FOT)--一种检测早期气道变化的新方法
根据世界卫生组织的数据,2019 年慢性阻塞性肺病(COPD)是全球第三大死因,造成 300 多万人死亡,而支气管哮喘影响到 2.5 亿多人,造成 45.5 万人死亡。这两种疾病都是慢性阻塞性疾病,需要及早诊断,以预防或减缓并发症。因此,世界需要新的不费力的方法来诊断气道阻塞,尤其是对幼儿和无法进行肺活量测定的人。本报告旨在描述强迫振荡技术(FOT)的目标,并确定其在临床实践中的应用。报告对有关肺功能测试的研究和临床案例进行了总结和分析。这些研究和案例可在以下数据库中找到:PubMed、Google Scholar 和 Science Direct。肺活量测定法是诊断气流阻塞的 "金标准",但需要患者付出努力,而且患者可能难以完成。另一方面,强迫振荡技术(FOT)是一种相对较新的方法,可能是识别与吸烟有关的呼吸系统早期改变和儿童哮喘的关键。FOT 要求潮式呼吸,同时施加外部小振幅振荡,以确定呼吸系统的反应。因此,学龄前儿童很容易操作。对于无法进行肺活量测定或其他肺功能测试的患者,应考虑到 FOT 的益处。患者只需极少的配合和简单的潮式呼吸操作使这种方法成为每个肺科医生的最佳选择。与肺活量测定法相比,该技术在检测外周气道紊乱方面更为敏感,可有效控制长期治疗。强迫振荡技术已成功应用于许多儿童呼吸系统疾病,如哮喘、囊性纤维化和慢性肺病。考虑到这些优点,FOT 可作为肺活量测定法的替代方法,用于治疗小气道异质性通气障碍。
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