Design and simulation-based evaluation of a novel tracheostomy high-flow therapy device interface: a preclinical study.

Background: High-flow tracheal oxygen (HFTO) does not generate significant positive end-expiratory pressure (PEEP), which may limit its clinical applicability. We designed a novel high-flow tracheal interface (nHFTI) and compared the PEEP and other respiratory parameters it generated with those of the traditional high-flow tracheal interface (tHFTI) across a range of flow rates. Methods: We conducted a randomized crossover bench study. A size 8 cuffed tracheostomy tube was connected to the high-flow therapy (HFT) device using two different interfaces. A high-fidelity lung simulator was used to model normal lung mechanics. Gas flow rates were set from 10 to 80 L/min at a gradient of 10 L/min, and the sequence was randomized. At each flow setting, the following parameters were recorded: PEEP, peak inspiratory pressure (PIP), peak expiratory pressure (PEP), end-inspiratory transpulmonary pressure (Ptp-EI), end-expiratory transpulmonary pressure (Ptp-EE), end-inspiratory cardiac pressure (PEIC) and end-expiratory cardiac pressure (PEEC), functional residual capacity (FRC), tidal volume (Vt) and fraction of inspired oxygen (FiO Results: As the HFT flow rate increased, PEEP increased significantly with both the tHFTI and nHFTI ( Conclusions: The nHFTI generated a modest level of PEEP, increased FRC and slightly reduced Vt at flow rates of 40-60 L/min. This physiological profile suggests potential for maintaining lung expansion and improving cardiac function in heart failure. Further