{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T05:04:55Z","timestamp":1788671095540,"version":"build-2803163510"},"reference-count":74,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Acute hypercapnic respiratory failure is a life-threatening condition caused by alveolar hypoventilation. It is mostly caused by an acute exacerbation of chronic obstructive pulmonary disease or conditions yielding muscle dysfunction. Noninvasive ventilation through a facemask is the cornerstone first-line strategy to support hypercapnic patients with acidemia, and current guidelines strongly recommend this intervention to improve survival and long-term clinical outcomes. Because of its benefits related to carbon dioxide washout from the upper airways and the enhanced comfort, high-flow nasal oxygen has been proposed as a respiratory support strategy in patients with hypercapnic respiratory failure, both as an alternative to and in combination with noninvasive ventilation. When compared to noninvasive ventilation as a first-line intervention, high-flow nasal oxygen shows a higher rate of failure. Hence, if not contraindicated, the use of noninvasive ventilation should be preferred. After the resolution of acidemia with noninvasive ventilation, high-flow nasal oxygen showed promising physiological effects compared to conventional oxygen. During weaning from mechanical ventilation in patients with or at risk of developing hypercapnia, high-flow nasal oxygen showed encouraging results, especially when applied alternating with sessions of noninvasive ventilation. Optimal settings of high-flow nasal oxygen in hypercapnic patients include the use of a smaller-size cannula, flows ranging between 30 and 40 L\/min, and FiO2 adjusted to obtain SpO2 between 88% and 92%. Specific interfaces, such as asymmetric cannulas, may further enhance the benefits of a high flow in terms of carbon dioxide clearance. In this narrative review, we provide an updated overview of the physiological rationale and clinical evidence concerning the use of high-flow nasal oxygen in patients with acute hypercapnic respiratory failure.<\/jats:p>","DOI":"10.3390\/jcm13216350","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T12:04:22Z","timestamp":1729685062000},"page":"6350","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["High-Flow Nasal Oxygen in Patients with Acute Hypercapnic Respiratory Failure: A Narrative Review of the Physiological Rationale and Clinical Evidence"],"prefix":"10.3390","volume":"13","author":[{"given":"Gabriele","family":"Pintaudi","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze dell\u2019Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8135-6284","authenticated-orcid":false,"given":"Salvatore Lucio","family":"Cutuli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-8328","authenticated-orcid":false,"given":"Tommaso","family":"Ros\u00e0","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biotecnologiche di Base Cliniche Intensivologiche e Perioperatorie, Universita\u2019 Cattolica del Sacro Cuore, Rome, L.go F. Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-5560","authenticated-orcid":false,"given":"Teresa","family":"Michi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Cardu","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biotecnologiche di Base Cliniche Intensivologiche e Perioperatorie, Universita\u2019 Cattolica del Sacro Cuore, Rome, L.go F. Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Bongiovanni","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"},{"name":"Dipartimento di Scienze Biotecnologiche di Base Cliniche Intensivologiche e Perioperatorie, Universita\u2019 Cattolica del Sacro Cuore, Rome, L.go F. Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4557-6308","authenticated-orcid":false,"given":"Domenico Luca","family":"Grieco","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy"},{"name":"Dipartimento di Scienze Biotecnologiche di Base Cliniche Intensivologiche e Perioperatorie, Universita\u2019 Cattolica del Sacro Cuore, Rome, L.go F. Vito 1, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3s","DOI":"10.1183\/09031936.03.00038503","article-title":"Respiratory failure","volume":"22","author":"Roussos","year":"2003","journal-title":"Eur. Respir. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1900164","DOI":"10.1183\/13993003.00164-2019","article-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: The gold science committee report 2019","volume":"53","author":"Singh","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1183\/09031936.00109906","article-title":"Exacerbations of chronic obstructive pulmonary disease","volume":"29","author":"Celli","year":"2007","journal-title":"Eur. Respir. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1136\/thx.2005.041830","article-title":"Copd exacerbations \u00b7 3: Pathophysiology","volume":"61","author":"Parker","year":"2006","journal-title":"Thorax"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1602426","DOI":"10.1183\/13993003.02426-2016","article-title":"Official ers\/ats clinical practice guidelines: Noninvasive ventilation for acute respiratory failure","volume":"50","author":"Rochwerg","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1007\/s00134-002-1478-0","article-title":"Noninvasive vs. Conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: A randomized trial","volume":"28","author":"Conti","year":"2002","journal-title":"Intensive Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1056\/NEJM199509283331301","article-title":"Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease","volume":"333","author":"Brochard","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1378\/chest.127.3.952","article-title":"Noninvasive positive-pressure ventilation to treat hypercapnic coma secondary to respiratory failure","volume":"127","author":"Diaz","year":"2005","journal-title":"Chest"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1016\/S0140-6736(00)02323-0","article-title":"Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: A multicentre randomised controlled trial","volume":"355","author":"Plant","year":"2000","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cammarota, G., Simonte, R., and De Robertis, E. (2022). Comfort during non-invasive ventilation. Front. Med., 9.","DOI":"10.3389\/fmed.2022.874250"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1007\/s00134-006-0324-1","article-title":"Benefits and risks of success or failure of noninvasive ventilation","volume":"32","author":"Demoule","year":"2006","journal-title":"Intensive Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1164\/rccm.201605-0916OC","article-title":"Physiologic effects of high-flow nasal cannula in acute hypoxemic respiratory failure","volume":"195","author":"Mauri","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s00134-017-4890-1","article-title":"Optimum support by high-flow nasal cannula in acute hypoxemic respiratory failure: Effects of increasing flow rates","volume":"43","author":"Mauri","year":"2017","journal-title":"Intensive Care Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1097\/CCM.0000000000002693","article-title":"Effects of high-flow nasal cannula on the work of breathing in patients recovering from acute respiratory failure","volume":"45","author":"Delorme","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1093\/bja\/aep280","article-title":"Nasal high-flow therapy delivers low level positive airway pressure","volume":"103","author":"Parke","year":"2009","journal-title":"Br. J. Anaesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s00134-021-06459-2","article-title":"Non-invasive ventilatory support and high-flow nasal oxygen as first-line treatment of acute hypoxemic respiratory failure and ARDS","volume":"47","author":"Grieco","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cutuli, S.L., Grieco, D.L., Michi, T., Cesarano, M., Rosa, T., Pintaudi, G., Menga, L.S., Ruggiero, E., Giammatteo, V., and Bello, G. (2023). Personalized respiratory support in ards: A physiology-to-bedside review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12134176"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1056\/NEJMoa1503326","article-title":"High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure","volume":"372","author":"Frat","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1001\/jama.2021.20714","article-title":"Effect of high-flow oxygen therapy vs. conventional oxygen therapy on invasive mechanical ventilation and clinical recovery in patients with severe COVID-19: A randomized clinical trial","volume":"326","author":"Garcia","year":"2021","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1001\/jama.2022.15613","article-title":"Effect of high-flow nasal cannula oxygen vs. standard oxygen therapy on mortality in patients with respiratory failure due to COVID-19: The soho-COVID randomized clinical trial","volume":"328","author":"Frat","year":"2022","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2226","DOI":"10.1007\/s00134-020-06312-y","article-title":"The role for high flow nasal cannula as a respiratory support strategy in adults: A clinical practice guideline","volume":"46","author":"Rochwerg","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2101574","DOI":"10.1183\/13993003.01574-2021","article-title":"Ers clinical practice guidelines: High-flow nasal cannula in acute respiratory failure","volume":"59","author":"Oczkowski","year":"2022","journal-title":"Eur. Respir. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1080\/15412555.2017.1315715","article-title":"Use of nasal high flow in stable copd: Rationale and physiology","volume":"14","author":"Pisani","year":"2017","journal-title":"J. Chronic Obstr. Pulm. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.pulmoe.2019.08.001","article-title":"High flow through nasal cannula in exacerbated copd patients: A systematic review","volume":"25","author":"Pisani","year":"2019","journal-title":"Pulmonology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jointm.2022.08.006","article-title":"Non-invasive ventilation for acute hypoxemic respiratory failure, including COVID-19","volume":"3","author":"Rosa","year":"2023","journal-title":"J. Intensive Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1002\/ppul.21326","article-title":"High-flow nasal cannula: Impact on oxygenation and ventilation in an acute lung injury model","volume":"46","author":"Frizzola","year":"2011","journal-title":"Pediatr. Pulmonol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1152\/japplphysiol.00934.2014","article-title":"Nasal high flow clears anatomical dead space in upper airway models","volume":"118","author":"Moller","year":"2015","journal-title":"J. Appl. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1152\/japplphysiol.00584.2016","article-title":"Nasal high flow reduces dead space","volume":"122","author":"Moller","year":"2017","journal-title":"J. Appl. Physiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13613-019-0597-5","article-title":"Effects of high-flow nasal cannula and non-invasive ventilation on inspiratory effort in hypercapnic patients with chronic obstructive pulmonary disease: A preliminary study","volume":"9","author":"Rittayamai","year":"2019","journal-title":"Ann. Intensive Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s44158-024-00173-3","article-title":"Effect of high-flow nasal cannula at different flow rates on diaphragmatic function in subjects recovering from an acute exacerbation of copd: A physiological prospective pilot study","volume":"4","author":"Castro","year":"2024","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1164\/ajrccm.163.6.2002129","article-title":"Function of pulmonary neuronal M2 muscarinic receptors in stable chronic obstructive pulmonary disease","volume":"163","author":"On","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1152\/jappl.1996.81.4.1739","article-title":"Changes in airway resistance induced by nasal inhalation of cold dry, dry, or moist air in normal individuals","volume":"81","author":"Fontanari","year":"1996","journal-title":"J. Appl. Physiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.4187\/respcare.02358","article-title":"Pressures delivered by nasal high flow oxygen during all phases of the respiratory cycle","volume":"58","author":"Parke","year":"2013","journal-title":"Respir. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1136\/thoraxjnl-2016-209673","article-title":"Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnic copd","volume":"72","author":"Pisani","year":"2017","journal-title":"Thorax"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1186\/s13613-018-0432-4","article-title":"High-flow nasal oxygen versus noninvasive ventilation in adult patients with cystic fibrosis: A randomized crossover physiological study","volume":"8","author":"Sklar","year":"2018","journal-title":"Ann. Intensive Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1007\/s00134-004-2320-7","article-title":"Noninvasive vs. invasive ventilation in copd patients with severe acute respiratory failure deemed to require ventilatory assistance","volume":"30","author":"Squadrone","year":"2004","journal-title":"Intensive Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Papachatzakis, Y., Nikolaidis, P.T., Kontogiannis, S., and Trakada, G. (2020). High-flow oxygen through nasal cannula vs. Non-invasive ventilation in hypercapnic respiratory failure: A randomized clinical trial. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17165994"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e506","DOI":"10.1097\/CCM.0000000000003740","article-title":"High-flow oxygen therapy after noninvasive ventilation interruption in patients recovering from hypercapnic acute respiratory failure: A physiological crossover trial","volume":"47","author":"Longhini","year":"2019","journal-title":"Crit. Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"180029","DOI":"10.1183\/16000617.0029-2018","article-title":"Noninvasive ventilation in acute respiratory failure: Which recipe for success?","volume":"27","author":"Scala","year":"2018","journal-title":"Eur. Respir. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1152\/japplphysiol.00692.2022","article-title":"Asymmetrical nasal high flow ventilation improves clearance of CO2 from the anatomical dead space and increases positive airway pressure","volume":"134","author":"Tatkov","year":"2023","journal-title":"J. Appl. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1186\/s13054-020-02980-w","article-title":"Effect of flow and cannula size on generated pressure during nasal high flow","volume":"24","author":"Pinkham","year":"2020","journal-title":"Crit. Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.clinbiomech.2017.11.003","article-title":"Correlation of high flow nasal cannula outlet area with gas clearance and pressure in adult upper airway replicas","volume":"66","author":"Moore","year":"2019","journal-title":"Clin. Biomech."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1186\/s13054-018-2107-9","article-title":"High-flow nasal cannula oxygen therapy decreases postextubation neuroventilatory drive and work of breathing in patients with chronic obstructive pulmonary disease","volume":"22","author":"Spadaro","year":"2018","journal-title":"Crit. Care"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1111\/resp.13050","article-title":"Physiological effects of titrated oxygen via nasal high-flow cannulae in copd exacerbations: A randomized controlled cross-over trial","volume":"22","author":"Pilcher","year":"2017","journal-title":"Respirology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3051","DOI":"10.2147\/COPD.S283020","article-title":"High-flow nasal cannula for chronic obstructive pulmonary disease with acute compensated hypercapnic respiratory failure: A randomized, controlled trial","volume":"15","author":"Li","year":"2020","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s13054-022-03973-7","article-title":"High-flow nasal cannula versus conventional oxygen therapy in acute copd exacerbation with mild hypercapnia: A multicenter randomized controlled trial","volume":"26","author":"Xia","year":"2022","journal-title":"Crit. Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.hrtlng.2023.02.016","article-title":"The use of high-flow nasal cannula in patients with chronic obstructive pulmonary disease under exacerbation and stable phases: A systematic review and meta-analysis","volume":"60","author":"Yang","year":"2023","journal-title":"Heart Lung"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"107465","DOI":"10.1016\/j.rmed.2023.107465","article-title":"High-flow nasal cannula may prolong the length of hospital stay in patients with hypercapnic acute copd exacerbation","volume":"220","author":"Xia","year":"2023","journal-title":"Respir. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1111\/crj.12772","article-title":"High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure","volume":"12","author":"Lee","year":"2018","journal-title":"Clin. Respir. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.2147\/COPD.S206567","article-title":"High flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: An observational cohort study","volume":"14","author":"Sun","year":"2019","journal-title":"Int. J. Chron. Obstruct. Pulmon. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/crj.13315","article-title":"Comparison of high-flow oxygenation with noninvasive ventilation in copd exacerbation: A crossover clinical trial","volume":"15","author":"Rezaei","year":"2021","journal-title":"Clin. Respir. J."},{"key":"ref_52","first-page":"10863","article-title":"Outcomes of high-flow nasal cannula versus non-invasive positive pressure ventilation for patients with acute exacerbations of chronic obstructive pulmonary disease","volume":"12","author":"Cong","year":"2019","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.hrtlng.2020.03.008","article-title":"The ventilatory effect of high velocity nasal insufflation compared to non-invasive positive-pressure ventilation in the treatment of hypercapneic respiratory failure: A subgroup analysis","volume":"49","author":"Doshi","year":"2020","journal-title":"Heart Lung"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1186\/s13054-020-03409-0","article-title":"High flow nasal therapy versus noninvasive ventilation as initial ventilatory strategy in copd exacerbation: A multicenter non-inferiority randomized trial","volume":"24","author":"Cortegiani","year":"2020","journal-title":"Crit. Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/s13054-022-04218-3","article-title":"High-flow nasal cannula versus non-invasive ventilation for acute hypercapnic respiratory failure in adults: A systematic review and meta-analysis of randomized trials","volume":"26","author":"Ovtcharenko","year":"2022","journal-title":"Crit. Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1186\/s13054-020-03214-9","article-title":"High-flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease patients after extubation: A multicenter, randomized controlled trial","volume":"24","author":"Tan","year":"2020","journal-title":"Crit. Care"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1164\/rccm.201208-1523CI","article-title":"The decision to extubate in the intensive care unit","volume":"187","author":"Thille","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2612","DOI":"10.1097\/CCM.0b013e3182282a5a","article-title":"Outcomes of extubation failure in medical intensive care unit patients","volume":"39","author":"Thille","year":"2011","journal-title":"Crit. Care Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.jcrc.2010.12.015","article-title":"Outcome of reintubated patients after scheduled extubation","volume":"26","author":"Esteban","year":"2011","journal-title":"J. Crit. Care"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/S2213-2600(18)30375-8","article-title":"Ventilatory support after extubation in critically ill patients","volume":"6","author":"Maggiore","year":"2018","journal-title":"Lancet Respir. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1001\/jama.2016.2711","article-title":"Effect of postextubation high-flow nasal cannula vs. conventional oxygen therapy on reintubation in low-risk patients: A randomized clinical trial","volume":"315","author":"Hernandez","year":"2016","journal-title":"JAMA"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1164\/rccm.201402-0364OC","article-title":"Nasal high-flow versus venturi mask oxygen therapy after extubation. Effects on oxygenation, comfort, and clinical outcome","volume":"190","author":"Maggiore","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"485","DOI":"10.4187\/respcare.02397","article-title":"High-flow nasal cannula versus conventional oxygen therapy after endotracheal extubation: A randomized crossover physiologic study","volume":"59","author":"Rittayamai","year":"2014","journal-title":"Respir. Care"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"562","DOI":"10.6061\/clinics\/2017(09)07","article-title":"The value of high-flow nasal cannula oxygen therapy after extubation in patients with acute respiratory failure","volume":"72","author":"Song","year":"2017","journal-title":"Clinics"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jcrc.2020.09.031","article-title":"The efficacy of the whisperflow cpap system versus high flow nasal cannula in patients at risk for postextubation failure: A randomized controlled trial","volume":"63","author":"Theerawit","year":"2021","journal-title":"J. Crit. Care"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1186\/s13054-021-03621-6","article-title":"Non-invasive ventilation versus high-flow nasal oxygen for postextubation respiratory failure in icu: A post-hoc analysis of a randomized clinical trial","volume":"25","author":"Thille","year":"2021","journal-title":"Crit. Care"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1164\/rccm.202201-0065OC","article-title":"High-flow versus venturimask oxygen therapy to prevent reintubation in hypoxemic patients after extubation: A multicenter randomized clinical trial","volume":"206","author":"Maggiore","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1186\/s40001-023-01076-9","article-title":"The efficacy of high-flow nasal cannula (hfnc) versus non-invasive ventilation (niv) in patients at high risk of extubation failure: A systematic review and meta-analysis","volume":"28","author":"Wang","year":"2023","journal-title":"Eur. J. Med. Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/nur.21942","article-title":"Comparison of high flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial","volume":"42","author":"Jing","year":"2019","journal-title":"Res. Nurs. Health"},{"key":"ref_70","first-page":"109","article-title":"A study on the effects and safety of sequential humidified high flow nasal cannula oxygenation therapy on the copd patients after extubation","volume":"98","author":"Zhang","year":"2018","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s00134-022-06919-3","article-title":"Effect of postextubation noninvasive ventilation with active humidification vs. high-flow nasal cannula on reintubation in patients at very high risk for extubation failure: A randomized trial","volume":"48","author":"Hernandez","year":"2022","journal-title":"Intensive Care Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1164\/rccm.202106-1452OC","article-title":"Beneficial effects of noninvasive ventilation after extubation in obese or overweight patients: A post hoc analysis of a randomized clinical trial","volume":"205","author":"Thille","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1186\/s13054-023-04441-6","article-title":"Effects of an asymmetrical high flow nasal cannula interface in hypoxemic patients","volume":"27","author":"Slobod","year":"2023","journal-title":"Crit. Care"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1152\/japplphysiol.90599.2008","article-title":"The principle of upper airway unidirectional flow facilitates breathing in humans","volume":"105","author":"Jiang","year":"2008","journal-title":"J. Appl. Physiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6350\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:18:59Z","timestamp":1760113139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,23]]},"references-count":74,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["jcm13216350"],"URL":"https:\/\/doi.org\/10.3390\/jcm13216350","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,23]]}}}