149 Does discharging infants home on caffeine affect the pattern of oxygen saturation?
Bibliographic record
Abstract
Apnea of prematurity (AOP) is common in preterm infants, and caffeine is the medication of choice. Caffeine increases minute ventilation, improves CO2 sensitivity and respiratory drive, as well as diaphragmatic contraction and respiratory muscle function. In VLBW infants caffeine given til 36 weeks corrected gestational age (CGA) improved survival without neurodevelopmental disability, and reduced need for positive airway pressure by 1 week and the rate of BPD. Discontinuation (d/c) of caffeine in hospital is not preventing infants from having episodes of intermittent hypoxia. Discharging home on caffeine could be an alternative to prolonged hospitalization. There are no studies evaluating the frequency of hypoxic episodes (HE) and SatO2 variability in infants from late prematurity to term, and in Calgary it is common to send infants with positive response home on caffeine. To describe the pattern of SatO2 before, during and after d/c caffeine in babies with AOP and, describe the pattern of SatO2 in babies with similar GA without AOP and to compare this to the SatO2 pattern of babies with AOP. We performed a cohort study in three groups of infants: Caffeine: Infants < 36 weeks of CGA, clinically ready for discharge, except for AOP. Control: Infants of similar GA without AOP at the time of discharge and Reference: healthy infants born > 35 weeks of GA and discharged home from postpartum.Descriptive analyses on mean SatO2, episodes of desaturation and duration (Mean, SD) were done. HE were periods >15 seconds of SatO2 <95%, 90% and 85%. To compare the mean levels of SatO2 over time linear mixed effects model with fixed effects for time and group, and random effect for subject was performed. A subanalysis of the caffeine group evaluating effect of d/c caffeine was done via a paired T test between weeks 43 and 45. 1426 recordings for 135 infants were analyzed. The model showed an effect of time .15 and differences between groups 2 and 3 to reference group, 1.72(95% CI(1.06, 2.39)) and 1.52(95% CI(0.94, 2.10)), yet no difference between groups 2 and 3. The average mean SpO2 was highest in the caffeine group. The paired T-test on the 9 subjects that had data in both weeks was not significant (p=0.18). The highest rate of HE was noted in groups 1 and 3 at 36 -38 weeks of CGA (p=0.11). The pattern of SatO2 before, during and after d/c of caffeine was not significantly different in infants discharged home on caffeine compare to the healthy infants of the similar age. Discharging home ex-preterm infants on caffeine does not increase risk of having hypoxic episodes.
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 | 0.000 | 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".