Risk factors associated with increased length of mechanical ventilation in children
Bibliographic record
Abstract
BACKGROUND: Invasive mechanical ventilation, if prolonged, may lead to high morbidity and mortality. OBJECTIVE: To determine the incidence rate and early risk factors for prolonged acute invasive mechanical ventilation in children. DESIGN: Retrospective longitudinal cohort study over a 1-yr period. PATIENTS: All consecutive episodes of invasive mechanical ventilation in the pediatric intensive care units of Sainte-Justine Hospital (Montreal, Canada) were included. Risk factors for long (≥96 hrs) vs. short (<96 hrs) duration of ventilation were determined by logistic regression. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Among the 360 episodes of invasive ventilation, 36% had a length of ≥96 hrs. Following multivariate analysis, significant risk factors for prolonged acute invasive mechanical ventilation were age of <12 months (odds ratio 3.27, 95% confidence interval 1.90-5.63), Pediatric Risk of Mortality score of ≥15 at admission (odds ratio 3.41, 95% confidence interval 1.31-8.89), mean airway pressure of ≥13 cm H(2)O on day 1 (odds ratio 5.92, 95% confidence interval 3.08-11.36), use of continuous intravenous sedation on day 1 (odds ratio 1.75, 95% confidence interval 1.00-3.05), and use of noninvasive ventilation before intubation (odds ratio 6.56, 95% confidence interval 1.99-21.63). CONCLUSIONS: Among the risk factors identified, the use of noninvasive ventilation and continuous intravenous sedation on the first day of ventilation are the only two interventions that were associated with prolonged acute invasive mechanical ventilation. Further research is needed to study the impact of sedation protocols on the duration of mechanical ventilation in children.
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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 | 0.003 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".