Comparison of High Flow vs Standard Nasal Cannula in Children With Burns Under Sedoanalgesia

Zeliha Alicikus50 enrolled

Overview

The aim of this study is to investigate the positive effects of high-flow oxygen therapy on the reduction of airway adverse events and recovery time compared to conventional nasal oxygen therapy in pediatric burns treated with procedural sedoanalgesia.

High flow nasal cannula oxygenation (HFNCO) has gained popularity in pediatric anesthesia practice. The basic mechanism of HFNCO involves reducing metabolic cost and work of breathing, decreasing nasopharyngeal resistance, and improving gas conditioning and secretion clearance. Heating and humidifying the oxygen administered make it easier for patients to tolerate high flow. The flow rate can be adjusted for all age groups. However, there are no studies in the literature investigating the effectiveness of HFNCO during procedural sedation in pediatric burn patients. This randomized prospective study was performed in 50 patients aged 1-14 years in the pediatric burn unit. Patients were divided into two groups as Group HFO: High flow oxygen (n: 25) and Group NC: nasal cannula oxygen (n: 25). Age, sex, burn percentage, concomitant diseases, ASA score, BMI (body mass index), respiratory and hemodynamic parameters, recovery time and presence of complications during sedoanalgesia were recorded.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Burns

Interventions

Conventional Nasal CannulaOTHER

The initial flow rate for nasal cannula oxygen was set at 3 L/min. In cases of hypoxia, the oxygen concentration was adjusted by increasing the flow rate by 1 to 2 L/min.

High-flow nasal cannulaOTHER

The high-flow nasal oxygenation device was set to a temperature of 36°C and an FiO2 of 0.4. The initial oxygen flow rate for the high flow group was determined according to the age and weight of the patients, based on our pediatric intensive care team's guidelines and the reference from the Slain study. When SpO2 fell below 94%, it was considered hypoxia, and the flow rate was increased by 2 to 4 L/min.

midazolam, ketamine, propofolDRUG

Sedation was done with IV midazolam 0.025 to 0.1 mg/kg, IV ketamine 0.25 to 0.5 mg/kg, and IV propofol (1%) 0.25 to 0.5 mg/kg

Eligibility

Sex: ALLMin age: 1 YearMax age: 14 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age: 1 and 14 years * ASA risk groups 1-3 * Second-degree burns covering more than 10% of the total body surface area, or third- and fourth-degree burns covering more than 2% of the total body surface area, burns involving the face, hands, feet, genital area, perineum, or major joints, electrical burns, and chemical burns. Exclusion Criteria: * Under 1 year of age or over 14 years of age * ASA score above 3 * Having restrictive or obstructive chronic respiratory diseases, active upper or lower respiratory infections, first-degree burns, and burns to the nasal area or respiratory tract.

Locations (1)

Umraniye Education and Research hospital

Istanbul, Turkey (Türkiye)

Outcomes

Primary Outcomes

Heart rate in beats per minute

Heart rate in beats per minute using ECG leads will be measured intraoperatively and postoperatively

Time frame: Intraoperative measurements will be taken at 0, 5, 15, 20 minutes and Postoperative measurements will be taken at 0, 5, and 10 minutes

Respiratory rate in breaths per minute

Respiratory rate in breaths per minute will be measured intraoperatively and post-operatively

Time frame: Intraoperative measurements will be taken at 0, 5, 15, 20 minutes and Postoperative measurements will be taken at 0, 5, and 10 minutes

SpO2 in percentage

SpO2 in percentage will be measured intraoperatively and post-operatively

Time frame: Intraoperative measurements will be taken at 0, 5, 15, 20 minutes and Postoperative measurements will be taken at 0, 5, and 10 minutes

End-tidal CO2 in mmHg

End-tidal CO2 in mmHg will be measured intraoperatively and post-operatively

Time frame: Intraoperative measurements will be taken at 0, 5, 15, 20 minutes and Postoperative measurements will be taken at 0, 5, 10 minutes and at recovery time60 minutes

Oxygen flow levels in Liters per minute

Oxygen flow levels in Liters per minute will be measured intraoperatively

Time frame: Intraoperative measurements will be taken at 0, 5, 15, 20 minutes

Secondary Outcomes

Need for oxygen assessed by SpO2

Need for oxygen assessed by SpO2 measured in percentage intraoperatively and post-operatively. SpO2 \<94% is considered desaturation

Time frame: Intraoperative measurements will be taken at 0, 5, 15, 20 minutes and Postoperative measurements will be taken at 0, 5, and 10 minutes

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.