AACN Adv Crit Care. 2025 Dec 15;36(4):336-345. doi: 10.4037/aacnacc2025174.

Noninvasive oxygen delivery methods, including high-flow nasal cannula therapy and noninvasive positive pressure ventilation, are essential tools in managing acute respiratory failure. These strategies offer effective oxygenation and ventilatory support while avoiding complications associated with invasive mechanical ventilation. This review explores the physiological principles, clinical indications, weaning, and comparative effectiveness of high-flow nasal cannula therapy and noninvasive positive pressure ventilation in patients with hypoxemic or hypercapnic respiratory failure. The article explores patient self-inflicted lung injury, which is associated with excessive respiratory muscle effort during noninvasive respiratory support. Early recognition, appropriate modality selection, and continuous monitoring are needed to prevent patient self-inflicted lung injury and improve patient outcomes. The use of predictive tools such as the respiratory oxygen index for evaluating high-flow nasal cannula therapy success is discussed. Through case-based analysis and evidence-based insights, the article highlights the importance of interdisciplinary collaboration and individualized care in optimizing noninvasive oxygen therapy.

PubMed:41364845 | DOI:10.4037/aacnacc2025174