[High-flow nasal therapy in the management of stable obstructive respiratory diseases]

High-flow nasal therapy is an emerging non-invasive method for managing patients with stable chronic obstructive pulmonary disease (COPD) or bronchiectasis. Through the physiological effects of high flow (positive expiratory pressure effect: reduced dead space, and decreased respiratory effort) and heated and humidified air (improved mucociliary clearance), high-flow nasal therapy reduces dyspnea and exacerbations, and may improve both quality of life and pulmonary rehabilitation outcomes. Recent studies suggest that it is particularly beneficial for COPD patients who are hypoxemic and present frequent exacerbations, or for those who are hypercapnic and intolerant to non-invasive ventilation. Despite these encouraging results, the lack of robust evidence and reimbursement still limits its integration into clinical practice.