Observational Study on the Effectiveness of Ventilator-Assisted Preoxygenation (VAPOX) Over Bag Valve Mask (BVM) Ventilation During Rapid Sequence Intubation in Patients with Acute Respiratory Distress

Purpose: To evaluate the effectiveness of Ventilator-Assisted Preoxygenation (VAPOX) compared with Bag Valve Mask (BVM) ventilation during Rapid Sequence Intubation (RSI) in patients presenting with acute respiratory distress. Materials and Methods: This observational study enrolled 60 critically ill patients requiring emergency intubation. Participants aged 40–90 years were consecutively allocated to receive preoxygenation by either VAPOX (n = 30) or BVM (n = 30). Heart rate, blood pressure, oxygen saturation (SpO2), and PaO2/FiO2 ratios were recorded at baseline, postpreoxygenation, and at 1, 5, and 30 minutes postintubation. Statistical analysis used SPSS software; significance was defined as P < 0.05. Results: Patients in the VAPOX group reached 95% SpO2 significantly faster than the BVM group (39 seconds vs. 80 seconds, P = 0.005), despite having a lower initial mean SpO2 (85.4% vs. 88.47%). Postpreoxygenation saturation was significantly higher with VAPOX (99.37%) than with BVM (96.90%) (P = 0.001). PaO2/FiO2 ratios at 5 minutes postintubation showed significant improvement in VAPOX compared with BVM (298.53 vs. 237.67; P = 0.007). Hemodynamic parameters showed no significant differences between groups. Conclusion: VAPOX is superior to BVM for preoxygenation during RSI in critically ill patients, demonstrating faster oxygenation, better maintenance of oxygen saturation, and significantly improved PaO2/FiO2 ratios, thereby minimizing transient and critical hypoxemia.