The efficacy of a novel peristaltic feeding tube (PFT) in reducing reflux and aspiration of gastric contents in mechanically ventilated patients
Bibliographic record
Abstract
Gastro-esophageal reflux (GER) is common in ventilated patients and is a cause of ventilator associated pneumonia (VAP). The novel persistaltic feeding tube (PFT) uses simulated peristalsis to seal the esophagus to fluid moving in a retrograde manner, whilst allowing normal drainage of fluid and secretions moving in an ante-grade manner. This study describes the first trial of the PFT in ventilated patients. Methods There were 10 subjects in the treatment (PFT) group and 10 patients in the control group, who had all undergone elective cardiac surgery and were ventilated in the intensive care unit (ICU) afterwards. The PFT was placed on admission to the ICU. In the control group a standard nasogastric tube (NGT) was inserted. Specimens were collected by suctioning from the oropharynx and from above the tracheal tube balloon every hour and from the trachea twice per 8 h shift. Samples were analyzed by ELISA for Pepsin A, as a marker for secretions of gastric origin. Esophageal pressure monitoring (as a measure of pleural pressure), which is an intrinsic ability of the PFT device, was also noted throughout the study – for future integration in mechanical ventilation strategies. Results The two groups were comparable with regard to demographics and duration of ventilation. There was a larger number of specimens positive for Pepsin A in the control group in the oropharynx (p < 0.0001) and above the ETT cuff (p = 0.0001), but not in the trachea (p = 0.0603), using the Wald Chi-squared test. However, when comparing mean concentrations of Pepsin at the three sites, there was a statistically higher concentration in the control group in the oropharynx, above the ETT and in the trachea, compared to the PFT group. Conclusion The PFT reduced the amount of GER in ventilated patients. A larger study is required to determine whether this translates to a reduction in VAP. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618000669291.
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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) | 0.001 | 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 | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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".