Which NIV settings are adequate for a patient with cardiogenic pulmonary edema?

The correct choice involves using mask CPAP settings at 8 - 12 cm H2O and 100% FiO2 for a patient with cardiogenic pulmonary edema. This approach is effective because it helps to recruit collapsed alveoli, improve oxygenation, and reduce the work of breathing in patients experiencing significant fluid accumulation in the lungs due to heart failure.

Using a continuous positive airway pressure (CPAP) of 8 - 12 cm H2O is typically effective in preventing airway collapse and ensuring that the airways remain open during the respiratory cycle. Coupled with the administration of 100% FiO2, this setting optimally improves oxygenation, which is crucial in treating hypoxemia often seen in cardiogenic pulmonary edema.

This method enhances lung inflation and promotes better ventilation-perfusion matching, which is pivotal in addressing the hypoxia resulting from fluid overload. It's essential to achieve a balance between effective ventilation and oxygenation without over-distending the lungs or causing further cardiovascular compromise, which could happen with inadequate pressure support or excessive FiO2 settings.

Other choices may not provide the necessary level of support or may increase the risk of complications. For instance, CPAP settings that are too low may not adequately open the air