P0435 / #2037: ELEVATED DIAPHRAGMATIC TONIC ACTIVITY IN CHILDREN: AN AGE-SPECIFIC DEFINITION PROPOSITION
Bibliographic record
Abstract
Aims & Objectives: Tonic diaphragmatic activity (Tonic Edi) represents patients’ efforts to increase lung recruitment. Its monitoring is a potential tool to titrate ventilation, but reference values are lacking. Our aims were 1) to define high tonic Edi in a pediatric critical care population; 2) to describe the occurrence of sustained high tonic Edi in the acute phase of ventilation. Methods: Using a high-resolution database, we retrospectively analyzed all patients admitted to our PICU between 2015 and 2020 who had continuous Edi monitoring. For aim 1, to target “near-normal” patients, the last 3 hours of Edi monitoring were examined and patients with signs of persistent active disease were excluded. The 97.5th percentile of expiratory phase Edi (Edimin) was computed in 3 age categories. This threshold was then used for aim 2 to identify patients with episodes of sustained (>1hr) elevated tonic Edi in the first 48h hours of monitoring (acute phase). Results: For objective 1, we included 221 patients. The 97.5th percentile of tonic Edi was 3 mcV for infants < 1y.o, 1.7 mcV for children 1-3 y.o. and 1.8 mcV for 4-18 y.o. (Figure 1). For objective 2, we included 431 patients and 12% (52/431) of them had ≥1 episode of sustained elevated tonic Edi in the acute phase.Conclusions: We propose an age-specific definition of elevated tonic Edi in PICU patients. Elevated tonic Edi episodes occur relatively frequently in the acute phase, suggesting efforts to increase lung recruitment. Further research is underway to explore if titration of PEEP could be guided by this marker.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".