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In these 2 patients, the HFNC was replaced with non-invasive positive pressure ventilation (NPPV). NPPV was also required at 16 to 168 hours after the initiation of HFNC in 5 of the 28 episodes in which the patient was initially responsive to HFNC, as the patients' respiratory symptoms gradually deteriorated. Performing HFNC with a home ventilator in CPAP mode is effective at treating bedridden patients with acute respiratory distress. However, it is essential that HFNC can be switched to NPPV if needed. Performing HFNC with a home vent