Multiorgan Dysfunction in Infants With Postasphyxial Hypoxic–Ischemic Encephalopathy
Bibliographic record
Abstract
Multiorgan dysfunction (MOD) is a consistent feature of the postasphyxial newborn infant. MOD is related to the diving reflex which, when activated by asphyxia, shunts blood from the skin and splanchnic region to the heart, adrenal glands, and brain. The presumed goal is to protect these vital organs from hypoxic–ischemic injury. This study examined patterns of involvement of major organ/systems and combinations of these in infants with postasphyxial hypoxic–ischemic encephalopathy (HIE), and associations between dysfunction and the long-term outcome. Outcome data were available for 130 infants who met 1 or more of 4 eligibility criteria: 1) a 5-minute Apgar score below 5, metabolic acidosis, and/or a lack of respiration for 5 minutes or longer; 2) a need for mechanical ventilation at birth; 3) evidence of encephalopathy (altered consciousness and/or seizures); and/or 4) complete functional assessment of the kidneys, cardiovascular system, lungs, and liver. Severe adverse outcomes (death from postasphyxial HIE, severe cerebral palsy diagnosed in the first year of life, mild or moderate cerebral palsy with blindness or deafness in the first year; moderate cerebral palsy with developmental delay at 21–24 months of age) were noted for 80 of 130 infants, 62% of the total. All infants had at least one organ dysfunction in addition to HIE. The incidence of renal, cardiovascular, pulmonary, and hepatic dysfunction ranged from 58% to 88% of infants having a good outcome and from 64% to 86% of those with an adverse outcome. Pulmonary and hepatic dysfunctions were most frequent. The rate of adverse outcomes increased from 1 to 3 as the number of additional organs involved increased from 1 to 3, but decreased when an additional 4 organs were involved. MOD was universally present in these infants with severe postasphyxial HIE, but was not associated with long-term outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".