Algorithm for BCPAP treatment in patients with ACPE in the CCU. Protocol as used for patients treated with BCPAP in the CCU. Since ACPE should respond within 30 minutes to BCPAP therapy, this protocol required early and frequent assessments of the patients' response. From left to right the duration of BCPAP treatment is displayed and from top to bottom the decreasing level of respiratory support. CR: clinical response is defined as an improvement in respiration rate and SpO2 to at least > 95%. Success was defined as achievement of CR with breathing oxygen through a ventimask. Note that, depending on the patients' response the protocol leads to a minimal duration of BCPAP of 30 minutes and a maximal duration of 2 hours.