{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:23:52Z","timestamp":1787217832001,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","award":["VTR TYH2022320"],"award-info":[{"award-number":["VTR TYH2022320"]}],"id":[{"id":"10.13039\/100008376","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":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n End\u2010tidal carbon dioxide capnography (EtCO\n 2<\/jats:sub>\n ) is widely used to guide intubated patients' ventilation. Current guidelines for prehospital advanced airway management assume a gradient of approximately 0.67\u2009kPa between EtCO\n 2<\/jats:sub>\n and arterial carbon dioxide partial pressure (PaCO\n 2<\/jats:sub>\n ). However, concerns have been raised about the accuracy of capnography. We aimed to assess the agreement between EtCO\n 2<\/jats:sub>\n and PaCO\n 2<\/jats:sub>\n in different patient groups to see if EtCO\n 2<\/jats:sub>\n could be accurate enough to guide ventilation during prehospital care.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We carried out a retrospective study of all anaesthetised and intubated patients with a measured PaCO\n 2<\/jats:sub>\n by a single helicopter emergency medical services unit from 1 January 2014 to 31 December 2021. The patients were divided into five different patient groups based on clinical diagnosis: out\u2010of\u2010hospital cardiac arrest, trauma, intoxication, neurological conditions (including stroke) and other. The agreement between EtCO\n 2<\/jats:sub>\n and PaCO\n 2<\/jats:sub>\n in each group was assessed with Bland\u2013Altman analysis. In addition, the percentage of patients with a higher PaCO\n 2<\/jats:sub>\n \u2013EtCO\n 2<\/jats:sub>\n gradient than 0.67\u2009kPa was calculated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In Bland\u2013Altman analysis, the overall bias was 1.7\u2009kPa (standard deviation\u2009=\u20091.6) with limits of agreement of \u22121.4 to 4.8\u2009kPa. Out of 670, the PaCO\n 2<\/jats:sub>\n \u2013EtCO\n 2<\/jats:sub>\n gradient was higher than 0.67\u2009kPa in 530 (79.1% [75.9\u201382.0]) patients. 186\/221 (84.2% [78.8\u201388.4]) in out\u2010of\u2010hospital cardiac arrest patients, 85\/104 (81.7% [73.2\u201388.0]) in trauma patients, 146\/197 (74.1% [67.6\u201397.7]) in neurological patients, 75\/99 (75.8% [66.5\u201383.1]) in intoxicated patients and 38\/49 (77.6% [64.1\u201387.0]) in other patients. The results are presented as n\/nn (% [95% confidence interval]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our results show that for critically ill patients intubated in the prehospital setting, capnography is not accurate in guiding ventilation.<\/jats:p>\n <\/jats:sec>\n \n Editorial Comment<\/jats:title>\n \n Capnography may be used to assess ventilation effect in intubated patients. In an intubated helicopter ambulance mixed\u2010diagnosis cohort end\u2010tidal carbon dioxide levers were assessed, compared to pCO\n 2<\/jats:sub>\n results from a point of care blood gas analysis device. The proportion of larger gaps between these two values in this mixed cohort is presented.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aas.70316","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:11:21Z","timestamp":1785334281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prehospital Normoventilation in Critically Ill Anaesthetised Patients Cannot Be Reliably Monitored by Capnography\u2014A Retrospective Observational Study"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6555-7131","authenticated-orcid":false,"given":"Jussi","family":"Tero","sequence":"first","affiliation":[{"name":"Emergency Medicine and Services University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9248-2235","authenticated-orcid":false,"given":"Jussi","family":"Pirneskoski","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3205-4949","authenticated-orcid":false,"given":"Harry","family":"Ljungqvist","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4566-8369","authenticated-orcid":false,"given":"Juri","family":"Laamanen","sequence":"additional","affiliation":[{"name":"University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1920-4869","authenticated-orcid":false,"given":"Jouni","family":"Nurmi","sequence":"additional","affiliation":[{"name":"Emergency Medicine and Services University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-023-01115-8"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000208359.74623.1C"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-023-07012-z"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/089771519200901S33"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1960.15.3.383"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/56.2.109"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13751"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2019-209077"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-89913-x"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1003800212"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.08.031"},{"issue":"9596","key":"e_1_2_13_13_1","first-page":"1453","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"370","author":"Elm E.","year":"2007","journal-title":"International Journal of Surgery"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14182"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-023-01086-w"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-020-0716-1"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-019-0265-y"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/48.8.719"},{"key":"e_1_2_13_19_1","first-page":"2570","volume-title":"Miller's Anesthesia","author":"Ko N. 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