The effects of manual hyperflation using self-inflating manual resuscitation bags on arterial oxygen tensions and lung compliance - Ameta-analysis of the literature
Bibliographic record
Abstract
The self-inflating manual resuscitation bag (MRB) is a modality which is commonly used by physiotherapists to manually hyperinflate the lungs of mechanically ventilated patients. There is limited scientific evidence to support its therapeutic use and the literature is not in agreement as to the effects of manual hyperinflation. A meta-analysis of the current research on humans has been conducted to investigate the effects of this modality on arterial oxygen tensions and lung compliance. All published studies evaluating the effects of manual hyperinflation (or bagging) on arterial oxygen tensions and/or lung compliance on mechanically ventilated patients have been retrieved. Only studies which reported results in terms of mean values and standard deviation or standard error of the mean could be used in this analysis. Eleven studies were identified between the time period 1968 -1995. Seven of these studies fitted the inclusion criteria. The mean and standard error of the mean values for arterial oxygen tensions (Pa02) and lung compliance (CL) have been used to calculate the 95% confidence intervals and these results were plotted on a graph. A comparative analysis has been performed on the results of the seven studies. A generally non-significant association between bagging and the Pa02 and CL values was demonstrated. Great discrepancies were identified in the designs of the seven included studies. Since the seven studies included in this meta-analysis show an overall non-significant association, it is reasonable to assume that the therapeutic value of the self-inflating manual resuscitation bag is questionable. The studies presented such divergent designs that they do not offer conclusive evidence. More standardized, multi-centre studies are required to clarify the therapeutic value of this modality. Other methods of recruiting the lungs of critically ill patients during and after physiotherapy intervention, need to be explored.
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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 | 0.017 | 0.034 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.038 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".