TY - JOUR T1 - High-flow nasal cannula and noninvasive ventilation: effects on alveolar recruitment and overdistension JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00127-2022 VL - 8 IS - 2 SP - 00127-2022 AU - Amandeep S. Saini AU - Simon Meredith AU - Antonio M. Esquinas AU - Bushra A. Mina Y1 - 2022/04/01 UR - http://openres.ersjournals.com/content/8/2/00127-2022.abstract N2 - We have read with great interest a study recently published in ERJ Open Research that analysed the ability of high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) to induce pulmonary expansion in acute hypoxaemic respiratory failure [1]. We would like to congratulate Artaud-Macari et al. [1] for their interesting observation using end-expiratory electrical lung impedance as a measuring tool. NIV certainly affects both dependent and non-dependent lung regions, which could increase tidal volume (VT) to >9.5 mL per kg predicted body weight and potentially exacerbate acute hypoxaemic respiratory failure. The authors concluded that, compared to NIV, HFNC contributes to lower risk of overdistension and fewer deleterious effects on global and regional VT, because the end-expiratory electrical lung impedance does not increase in non-dependent regions. Other studies, however, argue that HFNC may have similar negative effects to NIV, supported by four well-known determinants, as follows.Both high-flow nasal cannula and noninvasive ventilation are subject to pulmonary complications https://bit.ly/3jFCSG9 ER -