How to choose between high-flow nasal cannula, continuous positive airway pressure, and bilevel positive airway pressure in children with acute respiratory illness

In pediatric patients with acute respiratory illnesses, the widespread availability of heated humidified high-flow nasal cannula (HHHFNC) devices, ease of use, and increased compliance have increased their use in conditions such as pneumonia, acute respiratory failure, asthma, and acute respiratory distress syndrome. Due to the patient comfort and ease of use of HHHFNC, there are widely used. Similarly, the use of NIV is increasing due to the availability of better interfaces and non-invasive ventilators (NIV) for use in infants The conundrum has been regarding the generation of positive end-expiratory pressure in these open circuits of the HHHFNC devices versus the pressures delivered by the closed circuits in the NIV devices. This article reviewed the latest literature based on the clinical conditions and the rationale for selecting respiratory support in common acute respiratory illnesses.