When a patient crashes with acute cardiogenic pulmonary edema, emergency teams need fast, effective solutions. For years, non-invasive ventilation (NIV) has been the gold standard — but could high-flow nasal cannula (HFNC) be just as good?

In this episode, we break down a prospective, randomized trial published in the American Journal of Emergency Medicine (Dec 2025) that compared HFNC head-to-head with NIV in the ED. The results? No difference in survival, respiratory rates, or dyspnea scores between the two therapies.

We’ll explore:

• Why HFNC may rival NIV for managing ACPE

• The surprising equivalence in clinical outcomes at 30, 60, and 120 minutes

• Patient comfort and tolerability — where HFNC may hold the edge

• What this means for ED practice, protocols, and future airway management

If you’re an emergency physician, intensivist, or resuscitationist, this study has big implications: it suggests you may have more flexibility — and your patients, more comfort — than ever before.