{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T08:36:00Z","timestamp":1765874160158,"version":"3.48.0"},"reference-count":30,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:sub>2<\/jats:sub>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      As the HFT flow rate increased, PEEP increased significantly with both the tHFTI and nHFTI (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Compared with the tHFTI, the nHFTI generated significantly higher PEEP across most flow rates (\n                      <jats:italic>e.g.<\/jats:italic>\n                      , 3.4\n                      <jats:italic>vs.<\/jats:italic>\n                      1.0 cmH\n                      <jats:sub>2<\/jats:sub>\n                      O at 40 L\/min; 7.3\n                      <jats:italic>vs.<\/jats:italic>\n                      3.1 cmH\n                      <jats:sub>2<\/jats:sub>\n                      O at 60 L\/min, nHFTI\n                      <jats:italic>vs.<\/jats:italic>\n                      tHFTI, mean values). The nHFTI also generated higher PIP, PEP, Ptp-EI, Ptp-EE, PEIC, and PEEC, and resulted in a greater increase in FRC (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.010). Compared with the tHFTI, the nHFTI maintained a relatively constant FiO\n                      <jats:sub>2<\/jats:sub>\n                      and slightly reduced Vt at the same flow rate level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The nHFTI generated a modest level of PEEP, increased FRC and slightly reduced Vt at flow rates of 40\u201360 L\/min. This physiological profile suggests potential for maintaining lung expansion and improving cardiac function in heart failure. Further\n                      <jats:italic>in vivo<\/jats:italic>\n                      studies are needed to evaluate the clinical impact of nHFTI-mediated PEEP augmentation and determine whether it can lead to improved clinical outcomes, particularly in patients requiring prolonged mechanical ventilation during the weaning process.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20445","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T08:32:02Z","timestamp":1765873922000},"page":"e20445","source":"Crossref","is-referenced-by-count":0,"title":["Design and simulation-based evaluation of a novel tracheostomy high-flow therapy device interface: a preclinical study"],"prefix":"10.7717","volume":"13","author":[{"given":"Anna","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Mi","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengwei","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaohui","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"issue":"1","key":"10.7717\/peerj.20445\/ref-1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1186\/s13054-018-2126-6","article-title":"Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries","volume":"22","author":"Abe","year":"2018","journal-title":"Critical Care"},{"issue":"11","key":"10.7717\/peerj.20445\/ref-2","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1007\/s00134-019-05758-z","article-title":"What\u2019s new in intensive care: 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