Advances in Monitoring and Optimization of Non-Invasive Respiratory Support in Acute and Chronic Respiratory Failure

Dear Colleagues,

(1) Introduction

Respiratory failure remains a major global health challenge and a leading cause of morbidity and mortality worldwide. Recent advances in respiratory physiology, ventilatory strategies, and supportive technologies have significantly reshaped the management of both acute and chronic respiratory failure, highlighting the growing importance of tailored monitoring and individualized non-invasive respiratory support (NIRS).

Growing attention is devoted to the accurate monitoring of respiratory drive and inspiratory effort, which plays a key role in guiding individualized respiratory support strategies, supporting clinical decision-making, and identifying, at an early stage, patients with acute hypoxemic respiratory failure (AHRF) who are at risk of non-invasive support failure. The expanding use of non-invasive respiratory support modalities—such as high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV)—has further emphasized the need for reliable physiological monitoring to optimize patient selection, titrate therapy, and detect early signs of clinical deterioration. Particular challenges also arise in specific clinical populations, including immunocompromised patients with AHRF, in whom the role of NIRS remains debated.

Beyond the acute setting, similar challenges emerge in chronic respiratory failure, where long-term non-invasive ventilation and home respiratory support require dedicated monitoring strategies to assess patient–ventilator interaction, treatment adherence, and long-term physiological responses.

(2) Aim of the Special Issue

This Special Issue aims to provide an updated and clinically relevant overview of advances in the management of acute and chronic respiratory failure, with a particular focus on the monitoring of non-invasive respiratory support and personalized strategies.

In acute respiratory failure, improved monitoring of respiratory drive, inspiratory effort, and patient response to therapies such as HFNC and NIV may help clinicians identify early signs of treatment failure and guide timely escalation of care.

In parallel, chronic respiratory failure (CRF) represents a growing clinical burden, particularly in patients with chronic obstructive pulmonary disease (COPD) and obesity hypoventilation syndrome (OHS). In this setting, long-term home ventilation and remote monitoring strategies are increasingly important to assess treatment adherence, patient–ventilator interaction, and long-term clinical outcomes.

Overall, this Special Issue aims to explore emerging monitoring tools, physiological insights, and technological innovations that may help optimize non-invasive respiratory support across both acute and chronic respiratory failure.

The scope of this Issue aligns with the mission of the Journal of Clinical Medicine, promoting multidisciplinary contributions that advance the understanding and management of respiratory failure.

(3) Suggested themes and article types for submissions

This Special Issue aims to gather high-quality contributions addressing emerging challenges and innovations in the monitoring and optimization of NIRS across both acute and chronic respiratory failure. Research areas may include, but are not limited to, the following:

• Monitoring of respiratory drive and inspiratory effort during acute respiratory failure;
• Physiological monitoring during high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV);
• Early identification of patients at risk of non-invasive respiratory support failure;
• Patient–ventilator interaction and optimization of non-invasive respiratory support strategies;
• Non-invasive respiratory support during diagnostic and therapeutic procedures (e.g., bronchoscopy) and procedural sedation;
• Monitoring strategies for long-term non-invasive ventilation and home ventilation in chronic respiratory failure;
• Digital health technologies, telemonitoring, and remote patient management in respiratory care;
• Precision medicine, biomarkers, and artificial intelligence in respiratory failure monitoring;
• Clinical outcomes and long-term trajectories in patients receiving non-invasive respiratory support.

We look forward to receiving your valuable contributions.

Dr. Luca Novelli
Dr. Teresa Renda
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• acute and chronic respiratory failure
• acute hypoxemic respiratory failure (AHRF)
• acute respiratory distress syndrome (ARDS)
• respiratory monitoring
• respiratory drive
• inspiratory effort
• non-invasive ventilation (NIV)
• high-flow nasal cannula (HFNC)
• home ventilation
• telemonitoring