Breathing Easier: High-Flow Nasal Cannula Therapy – Transforming Respiratory Care from ICU to Home

Background: High-flow nasal cannula (HFNC) therapy is a non-invasive respiratory support modality offering physiological and comfort advantages over conventional oxygen delivery. Objective: To assess the efficacy, safety, and expanding indications of HFNC in adult patients across acute and chronic care settings. Methods: A systematic review of randomized trials, meta-analyses, and guidelines published between 2010 and 2025 was conducted. Outcomes included intubation rates, mortality, hospital stay, treatment failure, comfort, and adverse events. Results: HFNC reduced intubation rates in acute hypoxemic respiratory failure by 15–22%, with benefits in pneumonia and COVID-19. Post-extubating studies showed a 39% reduction in respiratory failure risk. In hypercapnic COPD, HFNC had similar mortality to non-invasive ventilation (NIV), though crossover to NIV increased in severe acidosis. Procedural sedation trials reported fewer hypoxemic events. Emerging data support HFNC in palliative care and home-based chronic respiratory failure. Economic modelling suggests ICU cost savings of up to $8,000 per admission. Conclusion: HFNC is effective across multiple respiratory conditions. Further research is needed to define its role in severe hypercapnia, optimize AI-guided titration, and assess cost-effectiveness in low-resource settings. Declaration of Generative AI During the preparation of this work the author used Microsoft Copilot to assist with language refinement and integration of updated evidence. The author reviewed and edited the content and takes full responsibility for the publication.