High-flow nasal cannula (HFNC) is a gas delivery system that provides heated and humidified air at higher flow rates than conventional oxygen therapy. While studies on the role of HFNC as a long-term treatment for chronic respiratory failure are limited, most of them focus on patients with chronic obstructive pulmonary disease. We present the case of a woman with severe bronchiectasis and chronic hypercapnic respiratory failure under nocturnal non-invasive ventilation (NIV) and 24-hour conventional oxygen therapy, who experienced multiple and prolonged hospital admissions. Long-term daytime HFNC was initiated, maintaining nocturnal NIV, resulting in significant improvements in dyspnea, better secretion management, and a reduction in exacerbation rates. While more research is needed, HFNC should be considered for long-term management of chronic respiratory failure in patients with bronchiectasis.

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