Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effect of Continuous Positive Airway Pressure on Short Term Inhospital Prognosis for Acute Pulmonary Edema
Brief Summary: The investigators hypothesise that CPAP + pharmaceutical treatment, compared to pharmaceutical treatment alone, improves the respiratory and hemodynamic status of the patients before H2 after the inclusion time and decreases the rate of death and tracheal intubation during the first 48 hours.


Options:
A: Inclusion Criteria:

* patient with supposed acute cardiogenic pulmonary edema, defined as acute dyspnea associated with a past of cardiomyopathy ischemia and physical signs consistent with pulmonary edema.
* patient giving written informed consent

Exclusion Criteria:

* Glasgow score \< 10
* Acute myocardial infarction ; ventricular arrhythmia ; pneumothorax ; evidence of pneumonia ; immediate need for intubation ; heart failure or respiratory stop witch requires a reanimation ; cardiogenic shock (systolic blood pressure \< 90 mmhg)
* Any neurological impairment that would prevent the protocol compliance
* participation in another study throughout this one
* women pregnant or nursing
* vomiting
* patient with an history of gastric surgery (\< 8days)
B: Inclusion Criteria:

* age \> 18
* acute respiratory insufficiency with hypoxia in air
* KILLIP score from 2 to 4
* absence of known ST elevation acute coronary syndrome
* accepted inform consent.

Exclusion Criteria:

* age \< 18
* immediate intubation criteria (bradypnea, coma status)
* refractory shock
C: Inclusion Criteria:

* rapid onset of the symptoms
* severe dyspnoea at rest
* respiratory rate \> 30 breaths per minute
* use of accessory respiratory muscles
* oxygen saturation (SpO2) inferior to 90% with an inspiratory oxygen fraction of 60% via a Venturi mask
* radiological findings of ACPE

Exclusion Criteria:

* acute ischemic heart disease (myocardial infarction, chest pain, ST elevation)
* hemodynamic instability (i.e. systolic blood pressure \< 90 with dopamine or dobutamine infusion ≥ 5 mcgr/Kg/min) or life-threatening arrhythmias
* need for immediate endotracheal intubation (respiratory arrest, bradypnea or gasping)
* inability to protect the airways
* impaired sensorium (i.e. unconsciousness or agitation)
* inability to clear secretions
* respiratory tract infection
* recent oesophageal/gastric surgery
* gastrointestinal bleeding
* facial deformities
* hematological malignancy or cancer with an Eastern Cooperative Oncology Group performance status ≥ 2
* chronic respiratory failure necessitating long-term oxygen therapy
* diagnosis of myocardial infarction, pulmonary embolism, pneumonia, exacerbation of chronic obstructive pulmonary disease, pneumothorax in the previous 3 months
* denial or refusal of intubation
* claustrophobia
* inclusion in other research protocols
D: Inclusion Criteria:

* Age\>18
* Either A or B

A. Clinical Criteria: Moderate to severe respiratory distress as evidenced by tachypnea, use of accessory muscles for breathing, or abdominal paradox.

B. Blood Gas and Physiologic Criteria: Gas exchange abnormalities including PaCO2\>45 with a pH\<7.35, or a PaO2/FiO2 ratio\<200.

Exclusion Criteria:

* The need for immediate intubation
* Medical instability such as hypotensive shock, uncontrolled cardiac ischemia or arrythmias, unstable myocardial infarction, uncontrolled upper gastrointestinal bleeding
* Agitation or uncooperativeness, unresponsive to small doses of sedatives
* Excretions or inability to protect the airway
* Inability to fit the mask
* Facial trauma
* Upper airway obstruction

Answer: B