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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">High-flow nasal cannula &#40;HFNC&#41; oxygen therapy is an innovative modality for early treatment of adults with respiratory failure and has physiological advantages compared to other standard oxygen therapies&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We read carefully the article by Demelo-Rodriguez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> and congratulate the authors on their study&#46; There are&#44; however&#44; some points to be taken into consideration&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">This study includes patients with different types of acute respiratory failure &#40;ARF&#41; which makes it difficult to establish which patients benefit most from HFNC&#46; It would&#44; therefore&#44; be useful to have larger and more randomized controlled trials&#44; with specific disorders such as chronic obstructive pulmonary disease &#40;COPD&#41; or idiopathic pulmonary fibrosis &#40;IPF&#41;&#44; to substantiate indications and criteria for the management of HFNC&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#8211;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In IPF&#44; the most common interstitial lung disease and with high mortality&#44; in which prognosis is extremely poor after mechanical ventilation&#44; HFNC appears to be an alternative modality for treating patients with hypoxemia who do not require immediate intubation&#44; providing better oxygenation&#44; dyspnea relief and comfort&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3&#44;5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The use of HFNC has also been described in stable hypercapnic COPD patients with interesting results&#44; such as increased tidal volume and reduction of respiratory rate&#44; minute volumes and capillary <span class="elsevierStyleItalic">p</span>CO<span class="elsevierStyleInf">2</span>&#44; enabling it to be an alternative to noninvasive ventilation&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> The dead space wash-out of the upper respiratory airway and the positive end expiratory pressure effect may contribute to these important effects of HFNC&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">HFNC is easy-to-use and is well tolerated&#44; as described in this study&#44; which was carried out in an Intermediate Care Unit&#46; In the future it may be used more frequently in hospital wards and help decrease admissions to intensive care units&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In short&#44; HFNC is a useful and exciting modality for the treatment of patients with respiratory failure and its use is growing worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
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