Ventilator-assisted preoxygenation in an aeromedical retrieval setting.

Area of Science:

• Emergency Medicine
• Critical Care
• Aeromedical Retrieval

Background:

• Ventilator-assisted preoxygenation (VAPOX) is established in hospital settings.
• Its application in aeromedical retrieval for critically unwell patients is less understood.

Purpose of the Study:

• To describe the use and efficacy of VAPOX during intubation in critically unwell patients during aeromedical retrieval.
• To evaluate its impact on oxygen saturation (SpO2).

Main Methods:

• Retrospective observational study of VAPOX use between January 2018 and December 2022.
• Data collected included patient demographics, clinical status, and VAPOX settings.
• Paired Student's t-tests analyzed SpO2 changes.

Main Results:

• VAPOX was used in 40 patients with diagnoses including pneumonia, COPD, and neurological conditions.
• A statistically significant increase in SpO2 was observed after VAPOX application (P < 0.001).
• Mean SpO2 improved significantly post-intubation compared to on arrival (P = 0.016), with low incidence of critical hypoxia and aspiration.

Conclusions:

• VAPOX is a viable option for pre-intubation optimization in the aeromedical retrieval environment.
• It effectively optimizes respiratory physiology, leading to a low incidence of critical hypoxia.
• While effective for oxygenation, a high incidence of hypotension was noted.