Purpose:High fow nasal cannula(HFNC)is a relatively recent respiratory support technique which delivers high fow,heated and humidifed controlled concentration of oxygen via the nasal route.Recently,its use has increased for a variety of clinical indications.To guide clinical practice,we developed evidence-based recommendations regarding use of HFNC in various clinical settings.

Methods:We formed a guideline panel composed of clinicians,methodologists and experts in respiratory medicine.Using GRADE,the panel developed recommendations for four actionable questions

Results:The guideline panel made a strong recommendation for HFNC in hypoxemic respiratory failure compared to conventional oxygen therapy(COT)(moderate certainty),a conditional recommendation for HFNC following extubation(moderate certainty),no recommendation regarding HFNC in the peri-intubation period(moderate certainty),and a conditional recommendation for postoperative HFNC in high risk and/or obese patients following cardiac or thoracic surgery(moderate certainty).

Conclusions:This clinical practice guideline synthesizes current best-evidence into four recommendations for HFNC use in patients with hypoxemic respiratory failure,following extubation,in the peri-intubation period,and postoperatively for bedside clinicians.