Respiratory outcomes during the use of the high flow nasal cannula in severe burn patients with inhalation injury: a systematic review

Introduction: patients with severe burns and inhalation injuries often require mechanical ventilation for life support. High-Flow Nasal Cannulas (HFNCs) represent non-invasive devices that may improve respiratory parameters. However, there is a lack of knowledge on using HFNCs in severe burn populations. The aim of the present work is that of describing the respiratory outcomes in severe burn patients with inhalation injury receiving oxygen therapy via HFNC. Materials and Methods: a systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies focusing on adult patients with severe burns and inhalation injuries treated with HFNC were included; pediatric populations and secondary studies were excluded. Results: of 796 records screened, three case series and one case report met the inclusion criteria and were included. The findings demonstrated that HFNCs significantly influenced key respiratory outcomes, including improvements in the P/F ratio (PaO₂/FiO₂), reduced respiratory rate, and successful weaning of ventilatory support. Conclusion: HFNC use appears safe and potentially beneficial for improving gas exchange in severe burn patients with inhalation injuries. However, the overall evidence remains limited. Further research is needed to confirm its efficacy and establish its role in standard burn care.