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Multiple trials support using noninvasive positive pressure ventilation (NPPV) in patients with chronic obstructive pulmonary disease exacerbations and cardiogenic pulmonary edema. NPPV is most effective in rapidly reversible conditions where supporting the work of breathing can allow pharmacologic interventions to take effect. Whether NPPV is beneficial in treating patients with hypoxemic respiratory failure (i.e., respiratory failure not secondary to conditions causing hypercarbia) is unclear. High-flow oxygen (HFO) generators are a relatively new addition to the spectrum of respiratory support. These set-ups allow for comfortable delivery of very high flows of oxygen (e.g., 60 L per minute). Flows are high enough to achieve low levels of…