Positive airway pressure therapy for heart failure

Table 4 Recommendations for oxygen and bi-level positive airway pressure therapy for acute decompensated heart failure

Guidelines	Oxygen	PAP therapy
ACC/AHA (2009 updated)	To relieve symptoms related to hypoxemia: Class I, level C	NA
ACCF/AHA (2013)	NA	NA
HFSA (2010)	Hypoxia+: Class I, level C	Dyspnea+ or pulmonary edema+: Class I, level A
	Hypoxia-: Class III, level C
ESC (2012)	Hypoxemia+ (SaO2 < 90% or PaO2 < 60 mmHg): Class I, level C	Dyspnea+ or pulmonary edema+ or RR > 20/min: Class IIa, level B SBP < 85 mmHg: Class III
JCS (2011)	Hypoxia+ (to keep SaO2 > 95%, PaO2 > 80 mmHg): Class I, level C	Not responding to oxygen: Class I, level A

ACC: American college of cardiology; ACCF: American college of Cardiology foundation; AHA: American heart association; ESC: European Society of Cardiology; HFSA: Heart failure society of America; JCS: Japanese Cardiology Society; NA: Not available; PaO₂: Arterial partial pressure of oxygen; RR: Respiratory rate; SaO₂: Oxyhemoglobin saturation; SBP: Systolic blood pressure; PAP: Positive airway pressure.