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. 2021 Jul 30;160(5):e399–e408. doi: 10.1016/j.chest.2021.05.075

Table 3.

List of Indications for Initiation of a BPAP Device

Any single criterion sufficient to initiate BPAP device in TRD.
  • 1.

    Symptoms plus a VC < 80%

  • ✓

    Orthopnea, dyspnea, morning headache, daytime sleepiness, or unrefreshing sleep

  • 2.

    CO2 measurement

  • ✓

    Daytime/awake Paco2 ≥ 45 mm Hg via ABG

  • ✓

    Etco2/Tcco2 or VBG Pco2 ≥ 50 mm Hg

  • 3.

    Sleep-related oxygen saturation from any source, including PSG/HST

  • ✓

    ≤ 90% for ≥ 5% of the night

  • ✓

    ≤ 88% ≥ 5 min

  • 4.

    VC (either FVC or slow VC)

  • ✓

    ≤ 50 % predicted

  • 5.

    MIP/SNIP- is less negative then the values below

  • ✓

    MIP less than or equal to –60 cm H2O (equal or worse than)

  • ✓

    Nasal SNIP less than or equal to –40 cm H2O (equal or worse than)

ABG = arterial blood gas; ALS = amyotrophic lateral sclerosis; BPAP = bilevel positive airway pressure; Etco2 = end-tidal CO2; HST = home sleep test; MIP = maximal inspiratory pressure; NIV = noninvasive ventilation; PSG = polysomnogram; SNIP = sniff nasal inspiratory pressure; Tcco2 = transcutaneous CO2; TRD = thoracic restrictive disorder; VBG = venous blood gas; VC = vital capacity.