Even as high-flow nasal cannula (HFNC) oxygen therapy is increasingly used in patients with exacerbation of COPD, the real effectiveness of β2 agonist nebulization through HFNC has been still poorly assessed. A recent study exploring the actual benefit of bronchodilators through HFNCs found that only salbutamol vibrating-mesh nebulization through high-flow nasal cannula (HFNC) induced a significant bronchodilator effect with volume and flow improvement. The study, published in Respiratory Care, hypothesized that salbutamol vibrating-mesh nebulization through HFNC improves pulmonary function tests in subjects with COPD. The researchers, after conducting a physiological crossover study including subjects admitted to the ICU for severe exacerbation of COPD, concluded that bronchodilators through HFNCs showed optimum results only with salbutamol vibrating-mesh nebulization. When the primary end point consisted of changes in FEV1 before and after salbutamol nebulization, secondary end points included the changes in FVC, peak expiratory flow (PEF), airway resistance, and clinical parameters. They found that among the 15 subjects included, mean (SD) FEV1 significantly increased after salbutamol nebulization from 931 mL (383) to 1,019 (432), mean difference +87 mL (95% CI 30–145) (P = .006).