High-flow nasal cannula (HFNC) and non-invasive ventilation(NIV) are commonly used for hypoxemic respiratory failure, but their comparative efficacy remains unclear. This prospective cohort study enrolled 259 non-hypercapnic hypoxemic respiratory failure patients (PaO₂ 0.05). HFNC and NIV show similar efficacy in preventing intubation and reducing mortality. NIV may shorten ICU stay in severe cases, but escalation to NIV or intubation after HFNC failure does not improve outcomes. Treatment should be individualized based on disease severity and patient response. However, given the non-randomized design and potential for residual confounding despite multivariate adjustment, these findings should be interpreted with caution and require validation in randomized controlled trials.
QianRu et al. (Mon,) studied this question.