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Hyperoxia induced hypercapnia has been described more than 60 years ago [1] and first recommendations to avoid hyperoxia in COPD patients were provided more than 50 years ago [2]. Alarm bell was recently raised [3] after the demonstration that high oxygen flows could increase mortality in patients with respiratory distress [4].

New device to support patients with acute respiratory distress: high flow, nebulization and oxygen therapy with automated fi02 titration