In the adult respiratory distress due to COPD bronchospasm, what CPAP setting is used in the first bundle?

• A. 5 cm H2O
• B. 15 cm H2O
• C. 20 cm H2O
• D. 10 cm/H2O

Answer: (D)

Continuous positive airway pressure helps by keeping airways open and maintaining alveolar recruitment throughout the breathing cycle, which reduces the work of breathing and improves oxygenation in acute COPD with bronchospasm. The best starting approach is a moderate CPAP level because it provides enough pressure to recruit collapsed airways and support oxygenation without pushing intrathoracic pressure high enough to reduce venous return or worsen air trapping. If the pressure is too low, alveolar recruitment may be inadequate and breathing remains strenuous; if it’s too high, it can cause hypotension and excessive hyperinflation, negating the benefits. So a middle-ground, moderate setting offers the optimal balance for initial management.