8: Tidal Volume Delivery During Mask Ventilation and Brain Injury in Newborns <29 Weeks Gestation
Bibliographic record
Abstract
Delivery of inadvertent high tidal volume (VT) during positive pressure ventilation (PPV) in the delivery room is common and associated with hemodynamic brain injury in animal models. To examine if high VT delivery during PPV at birth causes brain injury in preterm infants <29 weeks gestation. A flow-sensor was placed between the mask and the ventilation device. VT values were compared with recently described reference ranges for VT in spontaneously breathing preterm infants at birth. Infants were divided into two groups: VT < or >5.8 mL/kg (normal and high VT, respectively). Brain injury (eg, intraventricular hemorrhage (IVH)) was assessed using routine ultrasound imaging within the first days after birth. A total of 65 preterm infants were included, 49 (75%) had high VT and 16 (25%) normal VT. The mean (SD) gestational age and birth weight in high and normal VT group was similar, 26 (2) and 26 (1) weeks, 858 (251) g and 915 (250) g, respectively. IVH in the high VT group was diagnosed in 25 (51%) infants compared to two (13%) infants in the normal VT group (P=0.008). IVH in the high VT group was 12/25 grade I, 3/25 grade II, 1/25 grade III, and 9/25 had grade IV compared to 1/2 grade I, and 1/2 grade IV in the normal VT group. High VT delivery during mask PPV at birth is associated with hemodynamic brain injury. Strategies to limit VT delivery during mask PPV should be used to prevent high VT delivery.
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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 | 0.000 | 0.002 |
| 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".