There were no previous studies which specifically looked at the outcomes of CPAP in patients not suitable for invasive ventilation. A very small retrospective study published recently by Oranger M,et al., [7] commented that in 7 such patients intermittent CPAP improved survival when used early. The limitation of this study is the very small number of participants and it might be possible that the threshold for commencement of CPAP in  UK hospitals might differ from other European settings, as this study recruited patients who required just > 6lts/min  oxygen. It is clinically plausible that they might otherwise have survived with administration of higher concentration oxygen on its own.