The use of heated and humidified high flow nasal cannula (HFNC) has become increasingly popular in the treatment of patients with acute respiratory failure through all age groups. I first started using it as a pediatric intensive care fellow, but had little knowledge of how it actually worked. I noticed a few years after using it successfully in children, mainly with severe bronchiolitis, that we began to use it in the adult intensive care unit as well. It seems over the past several years many studies have come out reviewing the mechanisms of action as well as its use in a variety of conditions. In this part we will summarize how it works and for part 2 we will discuss the main indications for its use in adult and pediatric patients.

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