Welcome to the 9th EAPS Congress Programme Scheduling

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The Forced Oscillation Technique (FOT) (or Respiratory Oscillometry) measures the mechanical properties of the respiratory system (airways, lung tissue and rib cage) by applying a forcing signal at high frequency and small amplitude to the opening airways. The FOT differs from other techniques for assessing respiratory mechanics because of its ease of use at the bedside, non-invasivity (no muscle paralysis is required, nor the introduction of invasive devices such as an oesophagal balloon), and the applicability to uncooperative subjects. Respiratory mechanics by FOT can be obtained in patients mechanically ventilated or in high-frequency oscillatory ventilation or spontaneously breathing. Modern mechanical ventilators have integrated the possibility to assess respiratory mechanics by FOT without disconnecting the patients from the ventilatory circuit. In adult medicine, respiratory oscillometry allows tailoring mechanical ventilation (PEEP optimization) and follow-up of patients with chronic respiratory diseases (asthma, BPCO) to predict re-exacerbations and tailoring treatment. Recently the European Respiratory Society published the standard references for Respiratory Oscillometry in adult and pediatric patients.

Thanks to its non-invasivity and no need for patients cooperation, the FOT is a valuable tool for the clinical management of the respiratory issues of the newborn infant. During the talk, we will discuss how the FOT can be applied in neonatology:

- to improve knowledge of respiratory physiology in the clinical and preclinical setting

- to guide the lung recruitment at birth

- to tailor the ventilator setting (e.g. PEEP optimization)

- to follow up with patients and predict long term respiratory outcomes

- to tailor pharmacological treatment such as surfactant therapy.

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Heliox (helium-oxygen) is a special gas mixture that may be used instead of standard air-oxygen for neonatal ventilatory support. Unique physical properties of Heliox (e.g. low density) allow for improved gas flow and diffusion. The presentation will cover pathophysiologic rationale for the use of this mixture in the newborn and summarize available data regarding applications of Heliox in the NICU. Mechanisms of action and practical aspects of Heliox delivery will be also discussed; future research directions for neonatal use of Heliox will be proposed.