In COPD, Nocturnal Noninvasive Ventilation Reduces the F <sub> IO <sub>2</sub> </sub> Delivered Compared With Long-Term Oxygen Therapy at the Same Flow
Bibliographic record
Abstract
BACKGROUND: Nocturnal noninvasive ventilation is recommended for patients with hypercapnic COPD. Long-term oxygen therapy improves survival in patients with hypoxemic disease. However, leaks during noninvasive ventilation are likely to reduce the fraction of inspired oxygen. OBJECTIVES: To compare nocturnal inspired O 2 fractions during noninvasive ventilation with daytime pharyngeal inspired O 2 fractions during nasal cannula oxygen therapy (with the same O 2 flow) in patients with COPD at home (ie, real-life conditions). METHODS: This single-center prospective observational study included 14 subjects with COPD who received long-term O 2 therapy. We analyzed pharyngeal inspired O 2 fractions in the evening, with a nasopharyngeal probe (sidestream gas analyzer). The O 2 flow was measured with a precision flow meter, at the usual flow. Then, the same O 2 flow was implemented for noninvasive ventilation with a study’s home ventilator. The all-night noninvasive ventilation parameters were delivered in pressure mode with a single-limb leaking circuit. Daytime and nighttime inspired O 2 fractions were compared. RESULTS: The mean ± SD daytime pharyngeal inspired O 2 fraction, measured with normobaric basal O 2 flow, 0.308 ± 0.026%, was significantly higher than the mean ± SD nighttime inspired O 2 fraction, measured during noninvasive ventilation (0.251 ± 0.011; P < .001). CONCLUSIONS: The nighttime inspired O 2 fraction decreased with a modern noninvasive ventilation pattern, pressure target, and intentional leaks. This partial lack of O 2 therapy is likely to be harmful. It might explain the poor results in all but 2 randomized controlled trials on long-term noninvasive ventilation in COPD. (ClinicalTrials.gov registration NCT02599246.)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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 teacher head, 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".