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

Area of Science:

• Respiratory Physiology
• Medical Device Engineering

Background:

• High-flow tracheal oxygen (HFTO) therapy may have limited clinical use due to insufficient positive end-expiratory pressure (PEEP).
• A novel high-flow tracheal interface (nHFTI) was developed to potentially enhance PEEP generation.

Purpose of the Study:

• To compare the PEEP and other respiratory parameters generated by a novel high-flow tracheal interface (nHFTI) against a traditional interface (tHFTI).
• To evaluate the impact of different flow rates on respiratory mechanics using these interfaces.

Main Methods:

• A randomized crossover bench study using a high-fidelity lung simulator.
• Comparison of nHFTI and tHFTI connected to a tracheostomy tube across flow rates from 10 to 80 L/min.
• Measurement of PEEP, PIP, PEP, transpulmonary pressures, cardiac pressures, FRC, Vt, and FiO2.

Main Results:

• Both interfaces showed increased PEEP with higher flow rates (P < 0.001).
• nHFTI generated significantly higher PEEP (e.g., 7.3 vs. 3.1 cmH2O at 60 L/min) and other pressures compared to tHFTI.
• nHFTI increased functional residual capacity (FRC) and slightly reduced tidal volume (Vt) while maintaining FiO2.

Conclusions:

• The nHFTI produces modest PEEP, increases FRC, and slightly reduces Vt at 40-60 L/min.
• This profile suggests potential benefits for lung expansion and cardiac function in conditions like heart failure.
• Further in vivo studies are required to assess clinical outcomes, especially in patients undergoing mechanical ventilation weaning.