{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:28:17Z","timestamp":1770755297448,"version":"3.50.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010230","name":"Queensland Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Ventilator\u2010assisted preoxygenation (VAPOX) is a method of preoxygenation and apnoeic ventilation which has been tried in hospital setting. We aimed to describe VAPOX during intubation of critically unwell patients in aeromedical retrieval setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective observational study of VAPOX performed at LifeFlight Retrieval Medicine (LRM) between January 2018 and December 2022 across Queensland, Australia. Demographic and clinical data were recorded. Descriptive statistics and paired Student's <jats:italic>t<\/jats:italic>\u2010tests were used to evaluate the efficacy of VAPOX on oxygen saturation (SpO<jats:sub>2<\/jats:sub>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>VAPOX was used in 40 patients. Diagnoses included pneumonia (<jats:italic>n<\/jats:italic>\u2009=\u200911), COPD (<jats:italic>n<\/jats:italic>\u2009=\u20096) and neurological (<jats:italic>n<\/jats:italic>\u2009=\u20097). Patients were intubated in hospital (<jats:italic>n<\/jats:italic>\u2009=\u200936), in helicopter (<jats:italic>n<\/jats:italic>\u2009=\u20092) and ambulance (<jats:italic>n<\/jats:italic>\u2009=\u20092). Median VAPOX settings were: positive end\u2010expiratory pressure 6 (IQR 5\u20139), pressure support 10 (IQR 10\u201314) and back up respiratory rate 14 (IQR 11\u201318). Twelve agitated patients underwent delayed sequence induction with ketamine. There was a statistically significant increase in SpO<jats:sub>2<\/jats:sub> after application of VAPOX (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), followed by a slight decrease after intubation (<jats:italic>P<\/jats:italic>\u2009=\u20090.006). Mean SpO<jats:sub>2<\/jats:sub> were significantly improved after intubation compared with on arrival of LRM (<jats:italic>P<\/jats:italic>\u2009=\u20090.016). Hypotension was present prior to VAPOX (<jats:italic>n<\/jats:italic>\u2009=\u200913), during VAPOX (<jats:italic>n<\/jats:italic>\u2009=\u20092) and post\u2010intubation (<jats:italic>n<\/jats:italic>\u2009=\u200915). Two patients had cardiac arrest. Three patients were started on VAPOX but subsequently failed. There were no significant oxygen depletion or aspiration events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VAPOX can be considered for pre\u2010intubation optimisation in the retrieval environment. The incidence of post\u2010intubation critical hypoxia was low, and hypotension was high. Pre\u2010intubation respiratory physiology can be optimised by delivering variable pressure supported minute ventilation, achieving a low incidence of critical hypoxia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14404","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T05:29:26Z","timestamp":1710912566000},"page":"596-603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Ventilator\u2010assisted preoxygenation in an aeromedical retrieval setting"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4275-2588","authenticated-orcid":false,"given":"Akmez","family":"Latona","sequence":"first","affiliation":[{"name":"LifeFlight Retrieval Medicine  Toowoomba Queensland Australia"},{"name":"Emergency Department Ipswich Hospital  Ipswich Queensland Australia"},{"name":"School of Medicine, The University of Queensland  Brisbane Queensland 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Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-4552","authenticated-orcid":false,"given":"Gerben","family":"Keijzers","sequence":"additional","affiliation":[{"name":"Emergency Department Gold Coast University Hospital  Gold Coast Queensland Australia"},{"name":"School of Medicine, Griffith University  Gold Coast Queensland Australia"},{"name":"Faculty of Health Sciences and Medicine Bond University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Grant","sequence":"additional","affiliation":[{"name":"Emergency Department Gold Coast University Hospital  Gold Coast Queensland 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