Penicillium marneffei presenting as an obstructing endobronchial lesion in an immunocompetent host.

first-line treatment to improve gas exchange (89%) and was a valid tool as support to clearance techniques (68%) and to exercise training (43%). The main criteria to propose NIV, according to physiotherapists who use NIV (n528), were hypercapnic pulmonary exacerbation, awaiting lung transplantation, severe impairment of pulmonary function and difficulties experienced with clearing secretions (fig. 1). Almost all interviewees agreed that NIV was part of the ‘‘core competence’’ for physiotherapists who work in CF centres (95%) and clinics (85%). A detailed picture revealed that 71% (n520) of them chose ventilators, 96% were involved in the crucial choice of interfaces and 75% were in charge of ventilator settings. The majority (93%) took care of patients’ comfort and compliance enhancement and set frequent follow-ups to periodically review patients and, thus, improve their adherence. Although there are some limitations, this is the first Italian study that explores how physiotherapists are involved in the NIV management in CF centres and their expectations and beliefs about the benefits of NIV. Despite the absence of standard protocols and guidelines, Italian CF centres and clinics take into consideration the therapeutic use of NIV and physiotherapists are involved in its use. According to our results, the rationale of adopting NIV as a therapeutic choice in CF as perceived by physiotherapists is in line with what the literature has recently suggested [5]. Harmonising the core competencies of physiotherapists all over Italy and the NIV management of CF patients is, however, still urgently needed.