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Can High-Flow Oxygen Overstep Low-Flow Oxygen Therapy in Weaning From Noninvasive Ventilation in Patients With Acute Respiratory Failure Due to Chronic Obstructive Pulmonary Disease Exacerbation?

The authors reply: We are glad to read the letter by Nori et al (1), who provide preliminary data indicating that in patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring noninvasive ventilation (NIV) for hypercapnic acute respiratory failure (ARF), compared with standard oxygen therapy, high flow oxygen therapy (HFOT) at NIV discontinuation is associated with improved clinical outcome. Although the multiple mechanisms through which HFOT may be beneficial in COPD patients with respiratory insufficiency have been extensively described, the relative