Dear Sir,

Thank-you for your interest in our study and we are grateful for the opportunity to respond to your comments. In HFNC naïve units there is the opportunity to perform efficacy studies associated with the introduction of this mode of oxygen delivery toward particular patient populations. Our study differed as it purposefully sought to determine the feasibility, safety and cost-effectiveness of introducing a protocol in which HFNC was the primary oxygen delivery device in a unit in which HFNC was not uniformly applied