430
Bibliographic record
Abstract
Introduction: To compare mortality and duration of mechanical ventilation in patients with severe ARDS who were treated using veno-veno extracorporeal membrane oxygenator (ECMO) as an adjunct to mechanical ventilation versus those treated with conventional ventilation alone. Hypothesis: Veno-veno ECMO in conjunction with very low tidal volume ventilation confers a survival benefit in patients with severe ARDS. Methods: We conducted a multicenter, retrospective matched cohort study of patients who had veno-veno ECMO for severe ARDS according to the Berlin classification. Patients from January 2007 to January 2012 were included. Each patient who received ECMO was matched to a control patient who did not receive ECMO on the following factors: APACHE IV, clinical site, lowest PF ratio 12 hours prior to ECMO and age. Conditional logistic regression and Wilcoxon signed-rank testing of matched pairs was used for the analysis. Results: The cohort of 66 patients included 33 who received ECMO with their corresponding matched pair who did not receive ECMO. Overall mean age was 40 ± 15 years and 41 (62%) were male. Mortality for patients treated with ECMO was significantly lower than conventional mechanical ventilation (11[34%] vs 21[66%], p=0.03). There were more median days of ICU admission (15, IQR[9-31] vs 6[1-23], p=0.01) and hospital admission (24[17-43] vs 16[2-31], p=0.02) for patients on ECMO. There was no difference in median 28 ventilator free days (0[0-18] vs 0[0-6], p=0.24). Complications related to the ECMO circuit included 2(6%) patients with oxygenator failure, 1 (3%) pump failure and 3(8.6%) with recirculation. Patients with significant patient complications included 1 (3%) intracranial hemorrhage, 5 (15.1%) with minor extremity ischemia, 4 (12.1%) with gastro-intestinal bleed. Patients who survived and successfully weaned had improvement of their static compliance from initiation to weaning on ECMO (21.5 to 28.3, p=0.02) compared to those were unable to be weaned (19.2 to 12.2, p =0.23). Conclusions: In this matched cohort study, use of ECMO in patients with severe ARDS is safe and associated with lower hospital mortality than conventional mechanical ventilation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.003 |
| 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 | 0.000 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.502 | 0.382 |
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".