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Oxygen support level hierarchy. ARF often incorporates the top four rungs of support. In this diagram, non-rebreather masks often are temporizing measures that lead to escalation to HHHF, NIV, and above. Extracorporeal membrane oxygenation ECMO, invasive mechanical ventilation IMV, heated humidified high flow nasal cannula HHHF, non-invasive ventilation NIV, fraction of inspired oxygen FiO2; acute respiratory distress syndrome ARDS, liters per minute LPM.
