{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:28:12Z","timestamp":1780565292200,"version":"3.54.1"},"reference-count":19,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Noninvasive ventilation (NIV) improves the outcome of acute cardiogenic pulmonary edema (AcPE) and acute exacerbation of chronic obstructive pulmonary disease (aeCOPD) but is not recommended in pneumonia. The aim of this study was to assess the appropriateness of the use of NIV in a prehospital setting, where etiological diagnostics rely mainly on clinical examination. This observational multicenter retrospective study included all the patients treated with NIV by three mobile medical emergency teams in 2015. Prehospital diagnoses and hospital diagnoses were extracted from the medical charts. The appropriateness of NIV was determined by matching the hospital diagnosis to the current guidelines. Among the 14,067 patients screened, 172 (1.2%) were treated with NIV. The more frequent prehospital diagnoses were AcPE (n = 102, 59%), acute respiratory failure of undetermined cause (n = 46, 28%) and aeCOPD (n = 17, 10%). An accurate prehospital diagnosis was more frequent for AcPE (83\/88, 94%) than for aeCOPD (14\/32, 44%; p &lt; 0.01). Only two of the 25 (8%) pneumonia cases were diagnosed during prehospital management. Prehospital NIV was inappropriate for 32 (21%) patients. Patients with inappropriate NIV had a higher rate of in-hospital intubation than patients with appropriate NIV (38% vs. 8%; p &lt; 0.001). This high frequency of inappropriate NIV could be reduced by an improvement in the prehospital detection of aeCOPD and pneumonia.<\/jats:p>","DOI":"10.3390\/jcm10071359","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T14:51:12Z","timestamp":1616683872000},"page":"1359","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of Patients Treated with Prehospital Noninvasive Ventilation: Observational Retrospective Multicenter Study in the Northern French Alps"],"prefix":"10.3390","volume":"10","author":[{"given":"Julie","family":"Pinczon","sequence":"first","affiliation":[{"name":"SAMU 73, Centre Hospitalier M\u00e9tropole-Savoie, 73000 Chamb\u00e9ry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4036-6245","authenticated-orcid":false,"given":"Nicolas","family":"Terzi","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Unit, University Hospital of Grenoble Alps, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Usseglio-Polatera","sequence":"additional","affiliation":[{"name":"SAMU 73, Centre Hospitalier M\u00e9tropole-Savoie, 73000 Chamb\u00e9ry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ga\u00ebl","family":"Gheno","sequence":"additional","affiliation":[{"name":"SAMU 74, Centre Hospitalier Annecy Genevois, 74370 Epagny-Metz-Tessy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Savary","sequence":"additional","affiliation":[{"name":"Emergency Department, CHU d\u2019Angers, University Angers, 49000 Angers, France"},{"name":"IRSET (Institut de Recherche en Sant\u00e9, Environnement et Travail)\u2014UMR_S 1085, University Angers, 49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Debaty","sequence":"additional","affiliation":[{"name":"Emergency Department, SAMU 38, University Hospital of Grenoble Alps and University Grenoble Alps\/CNRS\/TIMC-IMAG UMR 5525, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Peigne","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Centre Hospitalier M\u00e9tropole-Savoie, 73000 Chamb\u00e9ry, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1602426","DOI":"10.1183\/13993003.02426-2016","article-title":"Official ERS\/ATS clinical practice guidelines: Noninvasive ventilation for acute respiratory failure","volume":"50","author":"Rochwerg","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_2","unstructured":"SRLF\u2014SFAR\u2014SPLF (2020, December 01). Ventilation Non Invasive au Cours de L\u2019insuffisance Respiratoire Aigu\u00eb [Internet]. Available online: http:\/\/www.srlf.org\/rc\/org\/srlf\/htm\/Article\/2012\/20121108-150108-850\/src\/htm_fullText\/fr\/2006_10_12_conference_de_consensus_commune_ventilation_non_invasive_resume.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1056\/NEJM199509283331301","article-title":"Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease","volume":"333","author":"Brochard","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3124","DOI":"10.1001\/jama.294.24.3124","article-title":"Noninvasive ventilation in acute cardiogenic pulmonary edema: Systematic review and meta-analysis","volume":"294","author":"Masip","year":"2005","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta19420","article-title":"Pre-hospital non-invasive ventilation for acute respiratory failure: A systematic review and cost-effectiveness evaluation","volume":"19","author":"Pandor","year":"2015","journal-title":"Health Technol. Assess. Winch. Engl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1007\/s00134-011-2311-4","article-title":"CPAP for acute cardiogenic pulmonary oedema from out-of-hospital to cardiac intensive care unit: A randomised multicentre study","volume":"37","author":"Ducros","year":"2011","journal-title":"Intensive Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.1093\/eurheartj\/ehm502","article-title":"A randomized study of out-of-hospital continuous positive airway pressure for acute cardiogenic pulmonary oedema: Physiological and clinical effects","volume":"28","author":"Plaisance","year":"2007","journal-title":"Eur. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.ajem.2018.07.001","article-title":"Prehospital non-invasive ventilation in acute respiratory failure is justified even if the distance to hospital is short","volume":"37","author":"Hensel","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1007\/s00134-006-0324-1","article-title":"Benefits and risks of success or failure of noninvasive ventilation","volume":"32","author":"Demoule","year":"2006","journal-title":"Intensive Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.ajem.2011.03.012","article-title":"Noninvasive ventilation use in French out-of-hospital settings: A preliminary national survey","volume":"30","author":"Templier","year":"2012","journal-title":"Am. J. Emerg. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ajem.2007.04.022","article-title":"An observational study of noninvasive positive pressure ventilation in an out-of-hospital setting","volume":"26","author":"Bruge","year":"2008","journal-title":"Am. J. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1001\/jama.2015.12402","article-title":"Effect of Noninvasive Ventilation vs. Oxygen Therapy on Mortality among Immunocompromised Patients with Acute Respiratory Failure: A Randomized Clinical Trial","volume":"314","author":"Lemiale","year":"2015","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13054-016-1586-9","article-title":"Use of noninvasive ventilation in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis","volume":"21","author":"Huang","year":"2017","journal-title":"Crit Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1056\/NEJMoa1503326","article-title":"High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure","volume":"372","author":"Frat","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s00134-019-05658-2","article-title":"High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: A systematic review and meta-analysis","volume":"45","author":"Rochwerg","year":"2019","journal-title":"Intensive Care Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13049-015-0134-y","article-title":"Implementation of the ABL-90 blood gas analyzer in a ground-based mobile emergency care unit","volume":"23","author":"Mikkelsen","year":"2015","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1007\/s00134-010-2076-1","article-title":"Accuracy of a transcutaneous carbon dioxide pressure monitoring device in emergency room patients with acute respiratory failure","volume":"37","author":"Gancel","year":"2011","journal-title":"Intensive Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.chest.2017.02.003","article-title":"Point-of-Care Ultrasonography for Evaluation of Acute Dyspnea in the ED","volume":"151","author":"Zanobetti","year":"2017","journal-title":"Chest"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13049-016-0288-2","article-title":"Prehospital lung ultrasound for the diagnosis of cardiogenic pulmonary oedema: A pilot study","volume":"24","author":"Laursen","year":"2016","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1359\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:41:11Z","timestamp":1760161271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/7\/1359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,25]]},"references-count":19,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["jcm10071359"],"URL":"https:\/\/doi.org\/10.3390\/jcm10071359","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,25]]}}}