SP488MYOCARDIAL STUNNING DURING RENAL REPLACEMENT THERAPY FOR ACUTE KIDNEY INJURY
Bibliographic record
Abstract
Introduction and Aims: The circulatory stress of chronic haemodialysis (HD) results in repetitive subclinical myocardial ischaemia (myocardial stunning), which contributes to adverse patient outcomes. Currently it is unknown whether this process occurs during renal replacement therapy (RRT) for acute kidney injury (AKI). Acute RRT differs in both its delivery and because patients do not display the circulatory changes of chronic uraemia that increase ischaemic susceptibility. We therefore aimed to determine whether acute RRT is capable of inducing myocardial stunning. Methods: 12 patients requiring RRT for AKI participated in an observational study. Serial echocardiography was performed before, during and after a single RRT session and images analysed off-line using speckle-tracking software. Myocardial stunning was defined as ≥2 new left ventricular (LV) regional wall motion abnormalities (RWMAs) during dialysis (>20% reduction in regional longitudinal strain); we used global longitudinal strain (GLS) to assess left ventricular contractility. Blood pressure (BP) and systemic haemodynamics were measured continuously using thoracic bioreactance. Intra-dialytic hypotension (IDH) was defined as >20mmHg fall in systolic blood pressure (SBP) or SBP <90mmHg.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.002 | 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 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".