High-flow nasal cannula oxygen therapy in the weaning of severe burn patients: a preliminary report of data collection

Inpatient care of severely burned patients is associated with a high morbidity and mortality rate. Burns, especially severe ones, are accompanied by an immune and inflammatory response and drastic metabolic changes that are hard to manage, which can shortly lead to multiple organ failure as well as lung failure. Weaning from mechanical ventilation represents the transition period from total ventilatory support to spontaneous breathing and can be performed with different strategies. The objective of this prospective study is to evaluate the clinical conditions of a series of patients weaned from mechanical ventilation with the aid of high flow nasal cannulas.

HFNC; Weaning; Burns

[1] Marc G Jeschke, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nature Reviews Disease Primers. 2020; 6: 11.

[2] Gigengack RK, Cleffken BI, Loer SA. Advances in airway management and mechanical ventilation in inhalation injury. Current Opinion in Anaesthesiology. 2020; 33: 774–780.

[3] Smailes ST. Noninvasive positive pressure ventilation in burns. Burns. 2002; 28: 795–801.

[4] Mancebo J. Weaning from mechanical ventilation. European Respiratory Journal. 1996; 9: 1923–1931.

[5] Xuan L, Ma J, Tao J, Zhu L, Lin S, Chen S, et al. Comparative study of high flow nasal catheter device and noninvasive positive pressure ventilation for sequential treatment in sepsis patients after weaning from mechanical ventilation in intensive care unit. Annals of Palliative Medicine. 2021; 10: 6270–6278.

[6] Sharon R Lewis, Philip E Baker, Roses Parker, Andrew F Smith. High-flow nasal cannulae for respiratory support in adult intensive care patients. Cochrane Database of Systematic Reviews. 2021; 3: CD010172.

[7] Wellington P Yamaguti, Eliana V Moderno, Sandra Y Yamashita, Thelma Gmc Gomes, Ana Lígia V Maida, Claudia S Kondo, et al. Treatment-related risk factors for development of skin breakdown in subjects with acute respiratory failure undergoing noninvasive ventilation or CPAP. Respiratory Care. 2014; 59: 1530–1536.

[8] Zhu Y, Yin H, Zhang R, Ye X, Wei J. High-flow nasal cannula oxygen therapy versus conventional oxygen therapy in patients after planned extubation: a systematic review and meta-analysis. Critical Care. 2019; 23: 180.

[9] Papazian L, Klompas M, Luyt C. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Medicine. 2020; 46: 888–906.

[10] American Burn Association. Advanced burn life support. 2018. Available at: http://www.ameriburn.org.

[11] Hirche Christoph, Kreken Almeland S, Dheansa B, Fuchs P, Governa M, Hoeksema H, et al. Eschar removal by bromelain based enzymatic debridement (Nexobrid®) in burns: European consensus guidelines update. Burns: Journal of the International Society for Burn Injuries. 2020; 46: 782–796.

[12] Yasuda H, Okano H, Mayumi T, Narita C, Onodera Y, Nakane M, et al. Post-extubation oxygenation strategies in acute respiratory failure: a systematic review and network meta-analysis. Critical Care. 2021; 25: 135.

[13] Lodeserto FJ, Lettich TM, Rezaie SR. High-flow nasal cannula: mechanisms of action and adult and pediatric indications. Cureus. 2018; 10: e3639.

[14] F. Simioli, A. Annunziata, G. Langella, G. E. Polistina, M. Martino, G. Fiorentino. Clinical outcomes of high-flow nasal cannula in COVID-19 associated postextubation respiratory failure. A single-centre case series. Anaesthesiology Intensive Therapy. 2020; 52: 373–376.

[15] Herrero De Lucas E, Sanchez-Sanchez M, Cachafeiro Fuciños L, Agrifoglio Rotaeche A, Martínez Mendez JR, Flores Cabeza E, et al. Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor. Burns: Journal of the International Society for Burn Injuries. 2020; 46: 1839–1847.