115
Bibliographic record
Abstract
Introduction: Over the last 10 years, animal models have raised concern about possible detrimental effects of some anesthetic drugs on the developing brain. There is controversy about whether the animal data can be extrapolated to humans. Hypothesis: We hypothesize that sedation/analgesia drugs used before, during and after infant cardiac surgery are associated with adverse neuro-developmental outcomes. Methods: A prospective follow-up project conducted in Western Canada including all infants age < 6 weeks having surgery for congenital heart disease (CHD) between April 2003 and December 2006 and without chromosomal abnormalities. Demographic and perioperative variables were collected prospectively. Sedation/analgesia variables were collected retrospectively. For each drug class (opioids, benzodiazepines, ketamine and chloral hydrate) we calculated: total cumulative dose received during hospitalization, average dose received per day, and cumulative number of days the patient received the drug. The following outcomes were assessed at age 4 years: Full Scale IQ (FSIQ), Performance IQ (PIQ), Verbal IQ (VIQ), Visual-Motor Integration (VMI), ABAS General Adaptive Composite (GAC) score. Multiple linear regression was used to analyze the data. Results: One hundred thirty five infants underwent surgery for CHD during the study period, 91 patients were available for the analysis. After adjusting for days on mechanical ventilation postoperatively and single ventricle repair, multiple linear regression analysis found that the total cumulative dose [58.8 (68.2) mg/kg] of benzodiazepines had a small but statistically significant association with lower VMI (Effect size -0.09; 95% CI -0.16, -0.02; P = 0.013), but not with FSIQ, PIQ, VIQ, or GAC. None of the other sedation/analgesia variables were associated with FSIQ, PIQ, VIQ, GAC, or VMI. Conclusions: This study is the continuation to age 4 years of a previously published follow-up project in children who underwent surgery for CHD in early infancy. Assessment of this cohort at an older age found a small but statistically significant negative association between benzodiazepine cumulative dose and VMI. No other association between sedation/analgesia drugs and outcomes were found.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.460 | 0.313 |
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".