{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:27:41Z","timestamp":1774978061872,"version":"3.50.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T00:00:00Z","timestamp":1636156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T00:00:00Z","timestamp":1636156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Acute Heart Failure (AHF) is a potentially lethal pathology and is often encountered in the prehospital setting. Although an association between prehospital arterial hypercapnia in AHF patients and admission in high-dependency and intensive care units has been previously described, there is little data to support an association between prehospital arterial hypercapnia and mortality in this population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a retrospective study based on electronically recorded prehospital medical files. All adult patients with AHF were included. Records lacking arterial blood gas data were excluded. Other exclusion criteria included the presence of a potentially confounding diagnosis, prehospital cardiac arrest, and inter-hospital transfers. Hypercapnia was defined as a PaCO<jats:sub>2<\/jats:sub> higher than 6.0\u2009kPa. The primary outcome was in-hospital mortality, and secondary outcomes were 7-day mortality and emergency room length of stay (ER LOS). Univariable and multivariable logistic regression models were used.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 225 patients in the analysis. Prehospital hypercapnia was found in 132 (58.7%) patients. In-hospital mortality was higher in patients with hypercapnia (17.4% [23\/132] versus 6.5% [6\/93], <jats:italic>p<\/jats:italic>\u2009=\u20090.016), with a crude odds-ratio of 3.06 (95%CI 1.19\u20137.85). After adjustment for pre-specified covariates, the adjusted OR was 3.18 (95%CI 1.22\u20138.26). The overall 7-day mortality was also higher in hypercapnic patients (13.6% versus 5.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.044), and ER LOS was shorter in this population (5.6\u2009h versus 7.1\u2009h, <jats:italic>p<\/jats:italic>\u2009=\u20090.018).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Prehospital hypercapnia is associated with an increase in in-hospital and 7-day mortality in patient with AHF.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12873-021-00527-y","type":"journal-article","created":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T10:03:44Z","timestamp":1636193024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Association between prehospital arterial hypercapnia and mortality in acute heart failure: a retrospective cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"Mathias","family":"Fabre","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe A.","family":"Fehlmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin E.","family":"Boczar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Gartner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine G.","family":"Zimmermann-Ivol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Sarasin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Suppan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,6]]},"reference":[{"issue":"12","key":"527_CR1","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1016\/j.rec.2016.10.015","volume":"37","author":"P Ponikowski","year":"2016","unstructured":"Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Soc Cardiol. 2016;37(12):2129\u2013200. https:\/\/doi.org\/10.1016\/j.rec.2016.10.015.","journal-title":"Eur Soc Cardiol"},{"issue":"231","key":"527_CR2","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/s1261-694x(14)70679-0","volume":"2014","author":"M Tubaro","year":"2014","unstructured":"Tubaro M, Price S, Vrints C. ESC Textbook of Intensive and Acute Cardiovascular Care. Arch Mal Coeur Vaiss Prat. 2014;2014(231):46. https:\/\/doi.org\/10.1016\/s1261-694x(14)70679-0.","journal-title":"Arch Mal Coeur Vaiss Prat"},{"key":"527_CR3","doi-asserted-by":"publisher","unstructured":"Meyer K, M\u00fcrner N, Laederach-Hofmann K, Simmet A, Hess OM. Heart failure events and case fatalities in Switzerland based on hospital statistics and cause of death statistics. Swiss Med Wkly. 2008. https:\/\/doi.org\/10.4414\/smw.2008.12304.","DOI":"10.4414\/smw.2008.12304"},{"issue":"2","key":"527_CR4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.ahj.2004.08.005","volume":"149","author":"KF Adams","year":"2005","unstructured":"Adams KF, Fonarow GC, Emerman CL, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the acute decompensated heart failure National Registry (ADHERE). Am Heart J. 2005;149(2):209\u201316. https:\/\/doi.org\/10.1016\/j.ahj.2004.08.005.","journal-title":"Am Heart J"},{"issue":"5","key":"527_CR5","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1016\/j.ahj.2010.07.020","volume":"160","author":"RD Kociol","year":"2010","unstructured":"Kociol RD, Hammill BG, Fonarow GC, Klaskala W, Mills RM, Hernandez AF, et al. Generalizability and longitudinal outcomes of a national heart failure clinical registry: comparison of acute decompensated heart failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries. Am Heart J. 2010;160(5):885\u201392. https:\/\/doi.org\/10.1016\/j.ahj.2010.07.020.","journal-title":"Am Heart J"},{"issue":"5","key":"527_CR6","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/j.jacc.2008.04.028","volume":"52","author":"WT Abraham","year":"2008","unstructured":"Abraham WT, Fonarow GC, Albert NM, Stough WG, Gheorghiade M, Greenberg BH, et al. Predictors of in-hospital mortality in patients hospitalized for heart failure. Insights from the organized program to initiate lifesaving treatment in hospitalized patients with heart failure (OPTIMIZE-HF). J Am Coll Cardiol. 2008;52(5):347\u201356. https:\/\/doi.org\/10.1016\/j.jacc.2008.04.028.","journal-title":"J Am Coll Cardiol"},{"key":"527_CR7","doi-asserted-by":"publisher","unstructured":"Tromp J, Ouwerkerk W, Cleland JGF, et al. Global Differences in Burden and Treatment of Ischemic Heart Disease in Acute Heart Failure. JACC Hear Fail. 2021;9(5). https:\/\/doi.org\/10.1016\/j.jchf.2020.12.015.","DOI":"10.1016\/j.jchf.2020.12.015"},{"issue":"22","key":"527_CR8","doi-asserted-by":"publisher","first-page":"2725","DOI":"10.1093\/eurheartj\/ehl193","volume":"27","author":"MS Nieminen","year":"2006","unstructured":"Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, et al. EuroHeart failure survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. Eur Heart J. 2006;27(22):2725\u201336. https:\/\/doi.org\/10.1093\/eurheartj\/ehl193.","journal-title":"Eur Heart J"},{"issue":"4","key":"527_CR9","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s00134-010-2113-0","volume":"37","author":"F Follath","year":"2011","unstructured":"Follath F, Yilmaz MB, Delgado JF, Parissis JT, Porcher R, Gayat E, et al. Clinical presentation, management and outcomes in the acute heart failure global survey of standard treatment (ALARM-HF). Intensive Care Med. 2011;37(4):619\u201326. https:\/\/doi.org\/10.1007\/s00134-010-2113-0.","journal-title":"Intensive Care Med"},{"issue":"4","key":"527_CR10","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1253\/circj.CJ-13-0187","volume":"77","author":"N Sato","year":"2013","unstructured":"Sato N, Kajimoto K, Keida T, Mizuno M, Minami Y, Yumino D, et al. Clinical features and outcome in hospitalized heart failure in Japan (from the ATTEND registry). Circ J. 2013;77(4):944\u201351. https:\/\/doi.org\/10.1253\/circj.CJ-13-0187.","journal-title":"Circ J"},{"issue":"6","key":"527_CR11","doi-asserted-by":"publisher","first-page":"349","DOI":"10.20452\/pamw.705","volume":"119","author":"JM Potts","year":"2009","unstructured":"Potts JM. Noninvasive positive pressure ventilation - effect on mortality in acute cardiogenic pulmonary edema: a pragmatic meta-analysis. Pol Arch Med Wewn. 2009;119(6):349\u201353. https:\/\/doi.org\/10.20452\/pamw.705.","journal-title":"Pol Arch Med Wewn"},{"issue":"4","key":"527_CR12","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1097\/CCM.0000000000000819","volume":"43","author":"L Cabrini","year":"2015","unstructured":"Cabrini L, Landoni G, Oriani A, Plumari VP, Nobile L, Greco M, et al. Noninvasive ventilation and survival in acute care settings: a comprehensive systematic review and metaanalysis of randomized controlled trials. Crit Care Med. 2015;43(4):880\u20138. https:\/\/doi.org\/10.1097\/CCM.0000000000000819.","journal-title":"Crit Care Med"},{"issue":"2","key":"527_CR13","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1056\/NEJMoa0707992","volume":"359","author":"A Gray","year":"2008","unstructured":"Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J. Noninvasive ventilation in acute cardiogenic pulmonary edema. N Engl J Med. 2008;359(2):142\u201351. https:\/\/doi.org\/10.1056\/NEJMoa0707992.","journal-title":"N Engl J Med"},{"issue":"1","key":"527_CR14","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1097\/mej.0000000000000616","volume":"1","author":"BA Gartner","year":"2019","unstructured":"Gartner BA, Fehlmann C, Suppan L, Niquille M, Rutschmann OT, Sarasin F. Effect of noninvasive ventilation on intubation risk in prehospital patients with acute cardiogenic pulmonary edema. Eur J Emerg Med. 2019;1(1):54\u20138. https:\/\/doi.org\/10.1097\/mej.0000000000000616.","journal-title":"Eur J Emerg Med"},{"issue":"1","key":"527_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S13049-021-00900-7","volume":"29","author":"A Dunand","year":"2021","unstructured":"Dunand A, Beysard N, Maudet L, et al. Management of respiratory distress following prehospital implementation of noninvasive ventilation in a physician-staffed emergency medical service: a single-center retrospective study. Scand J Trauma Resusc Emerg Med. 2021;29(1):1\u201312. https:\/\/doi.org\/10.1186\/S13049-021-00900-7.","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"4","key":"527_CR16","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1161\/CIRCHEARTFAILURE.111.964791","volume":"5","author":"S Chun","year":"2012","unstructured":"Chun S, Tu JV, Wijeysundera HC, Austin PC, Wang X, Levy D, et al. Lifetime analysis of hospitalizations and survival of patients newly admitted with heart failure. Circ Hear Fail. 2012;5(4):414\u201321. https:\/\/doi.org\/10.1161\/CIRCHEARTFAILURE.111.964791.","journal-title":"Circ Hear Fail"},{"issue":"6","key":"527_CR17","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.amjcard.2005.07.016","volume":"96","author":"M Gheorghiade","year":"2005","unstructured":"Gheorghiade M, De Luca L, Fonarow GC, Filippatos G, Metra M, Francis GS. Pathophysiologic targets in the early phase of acute heart failure syndromes. Am J Cardiol. 2005;96(6):11\u20137. https:\/\/doi.org\/10.1016\/j.amjcard.2005.07.016.","journal-title":"Am J Cardiol"},{"key":"527_CR18","doi-asserted-by":"publisher","unstructured":"Cunha FM, Cidade-Rodrigues C, Elias C, Oliveira D, Bettencourt P, Louren\u00e7o P. Glucose variability predicts 6-month mortality in patients hospitalized with acute heart failure. Intern Emerg Med. 2021. https:\/\/doi.org\/10.1007\/s11739-021-02719-7.","DOI":"10.1007\/s11739-021-02719-7"},{"issue":"5","key":"527_CR19","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1177\/2048872619858285","volume":"9","author":"X Rossello","year":"2020","unstructured":"Rossello X, Dorresteijn JA, Janssen A, et al. Risk prediction tools in cardiovascular disease prevention: a report from the ESC prevention of CVD Programme led by the European Association of Preventive Cardiology (EAPC) in collaboration with the acute cardiovascular care association (ACCA) and the Association of Cardiovascular Nursing and Allied Professions (ACNAP). Eur Hear J Acute Cardiovasc Care. 2020;9(5):522\u201332. https:\/\/doi.org\/10.1177\/2048872619858285.","journal-title":"Eur Hear J Acute Cardiovasc Care"},{"issue":"9","key":"527_CR20","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1161\/CIRCULATIONAHA.118.035509","volume":"139","author":"DS Lee","year":"2019","unstructured":"Lee DS, Lee JS, Schull MJ, Borgundvaag B, Edmonds ML, Ivankovic M, et al. Prospective validation of the emergency heart failure mortality risk grade for acute heart failure: the ACUTE study. Circulation. 2019;139(9):1146\u201356. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.118.035509.","journal-title":"Circulation"},{"issue":"1","key":"527_CR21","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1002\/ehf2.12023","volume":"2","author":"M Konishi","year":"2015","unstructured":"Konishi M, Akiyama E, Suzuki H, Iwahashi N, Maejima N, Tsukahara K, et al. Hypercapnia in patients with acute heart failure. ESC Hear Fail. 2015;2(1):12\u20139. https:\/\/doi.org\/10.1002\/ehf2.12023.","journal-title":"ESC Hear Fail"},{"issue":"9","key":"527_CR22","doi-asserted-by":"publisher","first-page":"610","DOI":"10.2459\/JCM.0000000000000079","volume":"16","author":"C Lazzeri","year":"2015","unstructured":"Lazzeri C, Gensini GF, Picariello C, Attan\u00e0 P, Mattesini A, Chiostri M, et al. Acidemia in severe acute cardiogenic pulmonary edema treated with noninvasive pressure support ventilation: a single-center experience. J Cardiovasc Med. 2015;16(9):610\u20135. https:\/\/doi.org\/10.2459\/JCM.0000000000000079.","journal-title":"J Cardiovasc Med"},{"issue":"1","key":"527_CR23","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12873-021-00411-9","volume":"21","author":"M Fabre","year":"2021","unstructured":"Fabre M, Fehlmann CA, Gartner B, Zimmermann-Ivoll CG, Rey F, Sarasin F, et al. Prehospital arterial hypercapnia in acute heart failure is associated with admission to acute care units and emergency room length of stay: a retrospective cohort study. BMC Emerg Med. 2021;21(1):14. https:\/\/doi.org\/10.1186\/s12873-021-00411-9.","journal-title":"BMC Emerg Med"},{"issue":"3","key":"527_CR24","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1177\/0885066616652597","volume":"33","author":"E Zeserson","year":"2018","unstructured":"Zeserson E, Goodgame B, Hess J, et al. Correlation of venous blood gas and pulse oximetry with arterial blood gas in the Undifferentiated Critically ill Patient. J Intensive Care Med. 2018;33(3):176\u201381. https:\/\/doi.org\/10.1177\/0885066616652597.","journal-title":"J Intensive Care Med"},{"issue":"2","key":"527_CR25","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1007\/s00134-016-4611-1","volume":"43","author":"N Nin","year":"2017","unstructured":"Nin N, Muriel A, Pe\u00f1uelas O, et al. Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome. Intensive Care Med. 2017;43(2):200\u20138. https:\/\/doi.org\/10.1007\/s00134-016-4611-1.","journal-title":"Intensive Care Med"},{"issue":"12","key":"527_CR26","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1164\/rccm.200309-1223OC","volume":"171","author":"CH Doerr","year":"2005","unstructured":"Doerr CH, Gajic O, Berrios JC, Caples S, Abdel M, Lymp JF, et al. Hypercapnic acidosis impairs plasma membrane wound reseating in ventilator-injured lungs. Am J Respir Crit Care Med. 2005;171(12):1371\u20137. https:\/\/doi.org\/10.1164\/rccm.200309-1223OC.","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"527_CR27","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/cc9325","volume":"14","author":"D Schlosshan","year":"2010","unstructured":"Schlosshan D, Elliott M. Prognostic indicators in patients presenting with acute cardiogenic pulmonary edema treated with CPAP: It\u2019s not the acid that matters, it\u2019s back to basics. Crit Care. 2010;14(6):14\u20135. https:\/\/doi.org\/10.1186\/cc9325.","journal-title":"Crit Care"},{"issue":"12","key":"527_CR28","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1002\/EJHF.153","volume":"16","author":"A Shoaib","year":"2014","unstructured":"Shoaib A, Waleed M, Khan S, Raza A, Zuhair M, Kassianides X, et al. Breathlessness at rest is not the dominant presentation of patients admitted with heart failure. Eur J Heart Fail. 2014;16(12):1283\u201391. https:\/\/doi.org\/10.1002\/EJHF.153.","journal-title":"Eur J Heart Fail"}],"container-title":["BMC Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-021-00527-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12873-021-00527-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-021-00527-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T22:02:47Z","timestamp":1636236167000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcemergmed.biomedcentral.com\/articles\/10.1186\/s12873-021-00527-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,6]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["527"],"URL":"https:\/\/doi.org\/10.1186\/s12873-021-00527-y","relation":{},"ISSN":["1471-227X"],"issn-type":[{"value":"1471-227X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,6]]},"assertion":[{"value":"23 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted at Geneva University Hospitals in accordance with Good Clinical Practice (Declaration of Helsinki 2002). This study was approved on 20.08.2019 by the institutional ethics committee of Geneva, Switzerland (Project ID 2019\u201301559). Patient consent was waived by this committee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"130"}}