How should oxygen be set on a BiPAP at the beginning of treatment?

Setting oxygen on a BiPAP at the beginning of treatment should involve matching the patient's previous FiO2 (fraction of inspired oxygen). This approach ensures that the patient receives an appropriate level of oxygen based on their previous requirements, which is critical for maintaining adequate oxygenation during the transition to noninvasive mechanical ventilation.

Every patient has unique oxygenation needs, and these are often based on their medical history, current condition, and previous treatment settings. By matching the prior FiO2, clinicians can avoid sudden changes that may lead to hypoxemia or other complications. It provides a tailored and responsive oxygen delivery system that considers the patient's baseline oxygenation levels, thereby ensuring that the patient remains stable and comfortable during the initiation of BiPAP therapy.

Using a fixed level of oxygen, setting it to a minimum, or maximizing oxygen flow without considering the patient's history might not effectively meet the individual needs of the patient and could lead to either insufficient or excessive oxygenation. This can compromise treatment effectiveness and patient safety.