116 Outcome at the Limit of Viability. Do guidelines work?
Bibliographic record
Abstract
To report the mortality, morbidity, and long term outcome of VLBW infants born at the limit of viability before and after implementing local resuscitation Guidelines. The Guidelines restrict aggressive resuscitation (Chest compressions and Epinephrine) of infants with birth weight <750 gm. Retrospective chart review of all infants born between 22–25 weeks gestation and infants with BW <750 gm from Jan 1998 to Dec 2003. The neonatal mortality, neonatal morbidity (IVH, PVL, BPD, and ROP) and outcome at 2 years of corrected age of survivors is reported prior and after implementing unit Resuscitation Guidelines. A total of 180 infants were studied. 93/180 (51.7%) survived until discharge. Survival improved with increasing gestational age. 20/180 (11.1%) infants were <500 gm birth weight. 2/20 (10%) survived until discharge. 157/180 (87.2%) infants were 501–750 gm birth weight. 91/160 (56.8%) survived until discharge. Use of chest compressions had no effect on short-term survival, but shifted deaths from the delivery room to NICU. Mortality was 8/12 (66.6%) in infants who received chest compressions + epinephrine. Use of chest compressions was less as compared to the period from 1994–1997, 6.6% vs 14%. Infants weighing <750 grams at birth who do not respond to intubation and ventilation should then receive comfort measures. Compressions should only be given under research study conditions, or if fully informed consent has been given by the parents, because of the high morbidity and mortality rates.
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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 | 0.010 | 0.065 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".