Start
Make initial settings:
EPAP: 4 cmH
2
O
O
2
: Current setting or per prescription
Max P: 25 cmH
2
O
Max V: 1000 to 1500 mL
PPV %: 80 to 100%
Max E: 5 cmH
2
O/L
Max R: 2 cmH
2
O/L/s
HIP: > Max P
Other settings: Per usual protocol
Yes
No
Is the patient using
accessory muscles to ac-
tively stop inspiration
?
Was the Max V or Max P
limit reached
?
Has the mask leak suddenly
increased?
No
No
No
Increase Max E by
2 cmH
2
O/L
Yes
Yes
Yes
No
Does the patient say the air
is coming too fast
?
Is the patient using
accessory muscles to ac-
tively stop inspiration
?
Was the Max V or Max P
limit reached
?
Has the mask leak suddenly
increased?
No
No
Increase Max R by
1 cmH
2
O/L/s
Reduce Max R by 1 cmH
2
O/L/s for
patient comfort
Yes
Yes
Yes
Yes
No
End
Titrate PPV % downward as tolerated
Does the patient say they
are getting too much air,
pressure, or volume
?
Reduce Max E
by 2 cmH
2
O/L for patient comfort
Max E
titration
Repeat Max E titration as needed
Max R
titration