RESULTS: Of 47 patients who received HFNO, 21 patients were treated for AHRF secondary to PNA. Of these, 15 were diagnosed with HCAP and 6 with CAP. Prior to the initiation of HFNO, the average supplemental O2 was 45.3%; 37.3% for HCAP and 67.5% for CAP, respectively. The supplemental oxygen devices used prior to HFNO differed in patients with CAP vs. HCAP: nasal cannula (16.7% vs. 53.3%), NIPPV (50% vs. 26.7%). In comparing the characteristics, the mean age was higher in CAP than HCAP, 75 and 60 years, respectively, and gender female (66% HCAP vs. 34% CAP. Comorbidities differed between patients with HCAP and CAP: malignancy (53.3%, 16.7%,) diabetes mellitus (53.3%, 50%), liver failure (13.3%, 0%), chronic renal failure (13.3%, 66.7%), HIV (13%, 0%), interstitial lung disease (16.7%, 6.7%), and non-small cell lung cancer (20%, 0%). At initiation of HFNO, 20% of HCAP patients were in shock compared to 33.3% of CAP patients. There were 2 patients that needed to be re-intubated after HFNO, 13.3% in HCAP vs. 0% in CAP. Mortality was lower in HCAP patients vs. CAP patients (33.3% vs. 83.3%). In addition, 66% of CAP patients were DNR/DNI compared to 26% of HCAP patients. All patients who died in either group were DNR/DNI and requested hospice care.