Abstract 8728: Nitric Oxide Delivery During Cardiopulmonary Bypass Reduces Postoperative Morbidity in Children - A Randomized Trial
Bibliographic record
Abstract
Background: Cardiac surgery leads to reperfusion injury and endothelial dysfunction causing fluid retention, coagulopathy, and myocardial dysfunction. Gaseous nitric oxide (gNO) has been demonstrated to have a myocardial protective effect and anti-reperfusion properties. We hypothesized that gNO administration during CPB would have similar beneficial effects. Methods: A prospective, randomized, blinded, placebo controlled study in which children undergoing repair of Tetralogy of Fallot received either 20 ppm of gNO or placebo delivered to the membrane oxygenator during CPB. Results: 16 children consented and randomized into 2 equal groups. There were no differences in age, cross clamp time, CPB time, or methemoglobin. The NO group had a shorter time on vent (8.4 +/- 7.6 vs 16.3 +/- 6.5 hrs, p<0.05) and CICU LOS (53.8 +/- 19.7 vs 79.4 +/- 37.7 hrs, p=0.05). The NO group had lower troponin values at 12, 24, and 48 hours (p<0.05) and lower BNP at 12 and 24 hours (p<0.05) (graphs). There was a trend toward less positive fluid balance in the first 48hrs post op (+187mL vs +317mL) with significantly less diuretic usage (1.6 +/- 0.9 vs 4.0 +/- 1.0 of furosemide, and 0 vs 6.3 +/- 7.4 of chlorothiazide, both mean total dose (mg/kg) in first 48 hrs, both p<0.05). NO patients had a higher mean Hgb at 48 hrs (11.8 vs 9.8, p<0.05) despite no differences in chest tube output, PRBC transfusion, platelet counts or transfusion, FFP transfusion, or pT/pTT in the first 48hrs. There were no differences in IL6, IL8, TNF, or lactate. Conclusions: The delivery of gNO to the CPB circuit in children undergoing cardiac surgery results in myocardial protection, improved fluid balance, and improved postoperative ICU course.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".