{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:58:22Z","timestamp":1785376702491,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004046","name":"Karen Elise Jensens Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004046","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010983","name":"Health Research Fund of Central Denmark Region","doi-asserted-by":"publisher","award":["R86\u2010A4134\u2010B877"],"award-info":[{"award-number":["R86\u2010A4134\u2010B877"]}],"id":[{"id":"10.13039\/501100010983","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009908","name":"Grosserer L. F. Foghts Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009908","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In\u2010hospital use of non\u2010invasive ventilation improves outcomes in patients with acute respiratory failure caused by acute exacerbation of chronic obstructive pulmonary disease. Prehospital use of non\u2010invasive ventilation is uncommon due to diagnostic uncertainty and logistical constraints. We hypothesised that prehospital non\u2010invasive ventilation guided by arterial blood gas analysis would improve early physiological outcomes compared with standard medical treatment alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This investigator\u2010initiated, multicentre trial randomised patients with suspected acute respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease with respiratory acidosis defined as pH &lt;\u20097.30 and PaCO\n                      <jats:sub>2<\/jats:sub>\n                      &gt;\u20096.0\u2009kPa to standard medical treatment alone or standard medical treatment plus non\u2010invasive ventilation. Patients were attended by prehospital physician\u2010manned emergency care units and enrolled without prior consent under emergency trial approval. The primary outcome was the change in arterial pH from enrolment to hospital arrival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The trial was terminated early due to low recruitment. Out of 111 screened patients, 16 were randomised and 14 were included in the analysis. The median prehospital pH change was 0.09 (interquartile range 0.02\u20130.12) in the non\u2010invasive ventilation + standard medical treatment group and 0.02 (0.01\u20130.03) in the standard medical treatment alone group. Median on\u2010scene time was 32\u2009min in the non\u2010invasive ventilation + standard medical treatment group versus 28\u2009min in the standard medical treatment alone group. Recruitment was limited by strict inclusion criteria, procedural complexity and challenges related to the implementation of prehospital arterial blood gas analysis and trial procedures. Missing data further limited the assessment of in\u2010hospital outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The clinical effect of prehospital non\u2010invasive ventilation could not be determined due to early termination. This trial highlights important challenges relevant to future clinical trials in the prehospital setting, including patient selection, diagnostic requirements and implementation of complex interventions.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      NCT06211920\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70269","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:10:36Z","timestamp":1780272636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prehospital Use of Non\u2010Invasive Ventilation for Acute Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease. A Randomised Trial"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7797-5717","authenticated-orcid":false,"given":"Jesper H.","family":"Brendel","sequence":"first","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5752-8082","authenticated-orcid":false,"given":"Lars W.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren H.","family":"Skaarup","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department for Respiratory Diseases and Allergy Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Dissing","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders Gunnar","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care Viborg Regional Hospital  Viborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaj F.","family":"Milandt","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care G\u00f8dstrup Regional Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrick S.","family":"Espelund","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care Horsens Regional Hospital  Horsens Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa F.","family":"Irion","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care Horsens Regional Hospital  Horsens Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone R.","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"Department of Anesthesiology and Intensive Care Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M.","family":"Larsen","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Central Denmark Region  Aarhus Denmark"},{"name":"The Elective Surgery Center Silkeborg Regional Hospital  Silkeborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Aage K.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Alarmerende h\u00f8j d\u00f8delighed blandt KOL\u2010patienter med akutte forv\u00e6rringer","author":"Albinus N.\u2010B.","year":"2022"},{"key":"e_1_2_11_3_1","unstructured":"Danish Respiratory Society \u201cKOL \u2013 Exacerbation og NIV. 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