Need for intubation in patients with acute respiratory failure remains important when respiratory condition deteriorates and places these severely hypoxemic patients at higher risks of desaturation than patients without respiratory failure (1). Between 30 to 40% of patients with acute respiratory failure will require intubation despite initial management with high flow nasal cannula (HFNC) oxygen (2-4).This figure is higher in patients initially treated with non-invasive ventilation or with standard conventional oxygen, in particular in those with a PaO 2 /FIO 2 below 200 (4,5). These patients are obviously at high risk of desaturation during the procedure.
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