The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 9: 1670 - 1680

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.09.024

Treatise: Clinical Practice

Validation of a novel high-flow tracheal interface with adjustable positive end-expiratory pressure in an ex vivo lung model of acute respiratory distress syndrome

  • Anna HOU ,
  • Ruonan XU ,
  • Fengwei JIAO ,
  • Song MI ,
  • Liming ZHANG
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  • Department of Respiratory and Critical Care Medicine，Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital，Capital Medical University，Beijing 100020，Beijing，China

Received date: 2026-01-04

  Online published: 2026-04-29

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Abstract

Objective High-flow tracheal oxygen （HFTO） often fails to generate effective positive end-expiratory pressure （PEEP） in tracheostomized patients with acute respiratory distress syndrome （ARDS） due to bypassed upper airway resistance. This study evaluated whether a novel high-flow tracheal interface could generate therapeutic PEEP levels and improve pulmonary mechanics in a mechanical lung model of ARDS. Methods In this randomized crossover bench study， an integrated system comprising a high-flow oxygen device， tracheostomy tube， and ARDS-programmed mechanical lung simulator （compliance： 51 mL/cmH?O； resistance： 5.1 cmH?O·s/L） was connected via either the novel or conventional interface. Gas flow was incrementally titrated from 10 to 80 L/min. Primary outcomes included PEEP， functional residual capacity （FRC）， tidal volume （Vt）， and FiO? delivery stability. Results At clinically relevant flow rates （40 ? 60 L/min）， the novel interface generated significantly higher PEEP （3.9 ? 7.3 cmH?O vs. 2.5 ? 5.0 cmH?O， P < 0.001） and FRC （P < 0.01） compared with the conventional interface， with only a modest reduction in Vt. FiO? stability remained comparable between interfaces （P ? 0.05）. PEEP demonstrated a robust power-function relationship with flow rate （R2 = 0.987）， enabling predictable pressure titration. Conclusion By simulating upper airway resistance， the novel high-flow tracheal interface effectively generates therapeutic PEEP levels， potentially facilitating lung recruitment in tracheostomized patients with ARDS.

Key words： high-flow tracheal oxygen; novel high-flow tracheal interface; positive end-expiratory pressure; functional residual capacity; tidal volume; acute respiratory distress syndrome

Cite this article

Anna HOU , Ruonan XU , Fengwei JIAO , Song MI , Liming ZHANG . Validation of a novel high-flow tracheal interface with adjustable positive end-expiratory pressure in an ex vivo lung model of acute respiratory distress syndrome[J]. The Journal of Practical Medicine, 2026 , 42(9) : 1670 -1680 . DOI: 10.3969/j.issn.1006-5725.2026.09.024

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