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Abstract Background: Despite being the gold standard for treatment of acute hypercapnic respiratory failure and its wide potential for application, NIV use can be limited due to patient intolerance of the interface or positive pressure. High-flow nasal cannula is a newly-introduced oxygen delivery device that has been studied in the hypoxemic respiratory failure. It is of increasing interest as an alternative to NIV in hypercapnic respiratory failure. Aim: to assess efficacy, and safety of high flow nasal cannula as an alternative to non-invasive positive pressure ventilation in management of acute hypercapnic respiratory failure. Methods: 46 patients with acute hypercapnic respiratory failure were enrolled. They were subjected basically to written informed consent, clinical data collection, laboratory investigations, chest x-ray, one group received HFNC and the other group received NIV. Results: There was no significant difference between the HFNC and NIV groups in the terms of success rate (60.9% versus 69.6%), length of ICU stay (11.35 ± 5.61 days versus 11.43 ± 6.67 days). However, there was statistically significant difference between the 2 groups in the terms of ICU mortality (17.4% for the HFNC group, versus 52.2% for the NIV group). Conclusion: HFNC can be a good alternative to NIV in management of acute hypercapnic respiratory failure. |