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• Because of differences in respiratory physiology, children are more susceptible than adults to severe manifestations of respiratory diseases, which in some cases lead to blood oxygen desaturation. • Hypoxemia associated with severe respiratory diseases is a major criterion for hospitalization and is more common in young patients. • Administration of simple oxygen is indicated when hypoxemia is the only complication and no hypercapnia is present. • Patients with significant respiratory distress may benefit from HFNC, helmet ventilation or CPAP. These procedures must be closely monitored and performed by trained staff. • If ventilatory support is needed, NIV is the method of choice whenever possible and safe. It doesn’t disrupt swallowing, feeding, speaking or coughing, and preserves the vocal cords and trachea. It also reduces the risk of infection and the length of stay in pediatric intensive care units.