Successful use of high-flow nasal cannula to treat hemoptysis and acute global respiratory failure in two cystic fibrosis bronchiectasis patients and review of the current literature

Cystic fibrosis (CF) is a multisystemic disease, and despite the continuous improvement in understanding its pathophysiology and the present therapeutic possibilities, complications may occur. Indeed, literature shows that the onset of hemoptysis is a common complication reported in CF patients: in this context, the high-flow nasal cannula (HFNC) respiratory support has recently gained more importance because it helps increase the hygroscopic degree in the bronchial secretions by improving ciliary function and mucus hydration; thus, it reduces the patients’ work of breathing, and through high air flow, it reduces dead space in hyperinflated patients, and we carefully review the current literature on this topic. In this manuscript, we describe two cases of HFNC use for the successful treatment of global respiratory failure and hemoptysis in patients affected by CF bronchiectasis on chronic home oxygen therapy. This could add more treatment possibilities in this patient population to cure life-threatening complications related to severe CF disease.