Evaluating the ventilatory effect of transnasal humidified rapid insufflation ventilatory exchange in apnoeic small children with two different oxygen flow rates: a randomised controlled trial <sup>*</sup>
Bibliographic record
Abstract
Summary Transnasal humidified rapid insufflation ventilatory exchange prolongs safe apnoeic oxygenation time in children. In adults, transnasal humidified rapid insufflation ventilatory exchange is reported to have a ventilatory effect with PaCO 2 levels increasing less rapidly than without it. This ventilatory effect has yet to be reproduced in children. In this non‐inferiority study, we tested the hypothesis that children weighing 10–15 kg exhibit no difference in carbon dioxide clearance when comparing two different high‐flow nasal therapy flow rates during a 10‐min apnoea period. Following standardised induction of anaesthesia including neuromuscular blockade, patients were randomly allocated to high‐flow nasal therapy of 100% oxygen at 2 or 4 l.kg −1 .min −1 . Airway patency was ensured by continuous jaw thrust. The study intervention was terminated for safety reasons when SpO 2 values dropped < 95%, or transcutaneous carbon dioxide levels rose > 9.3 kPa, or near‐infrared spectroscopy values dropped > 20% from their baseline values, or after an apnoeic period of 10 min. Fifteen patients were included in each group. In the 2 l.kg −1 .min −1 group, mean (SD) transcutaneous carbon dioxide increase was 0.46 (0.11) kPa.min −1 , while in the 4 l.kg −1 .min −1 group it was 0.46 (0.12) kPa.min −1 . The upper limit of a one‐sided 95%CI for the difference between groups was 0.07 kPa.min −1 , lower than the predefined non‐inferiority margin of 0.147 kPa.min −1 (p = 0.001). The lower flow rate of 2 l.kg −1 .min −1 was non‐inferior to 4 l.kg −1 .min −1 relative to the transcutaneous carbon dioxide increase. In conclusion, an additional ventilatory effect of either 2 or 4 l.kg −1 .min −1 high‐flow nasal therapy in apnoeic children weighing 10–15 kg appears to be absent.
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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 | 0.001 | 0.000 |
| 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 | 0.000 | 0.000 |
| 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".